Many transgender and gender nonconforming (TGNC) clients seek to obtain referral letters for gender affirming medical treatment from their mental health providers, but little is known about how the process of obtaining referral letters impacts TGNC clients' therapy experiences. We conducted semistructured interviews with 15 TGNC individuals who obtained a referral letter for gender affirming medical intervention from their therapists. Thematic analysis revealed 2 core themes: (a) "bullsh ‫ء‬ t" (or "BS") participants endured due to the referral letter requirement and (b) "blessings" that TGNC individuals experienced because of this requirement. Participants revealed that they had better therapy experiences when their therapists actively affirmed their gender and choices related to transition, acted to facilitate transition, provided knowledge and resources to help them navigate transition, and collaborated with them to determine the focus of therapy. Recommendations for training, practice, and future research are provided. Public Significance StatementTransgender and gender nonconforming (TGNC) therapy clients identified both positive and negative experiences related to obtaining referral letters for gender affirming medical treatment. Clients who experienced the letter process negatively noted lost time and money, felt stigma, and sensed added strain in their therapeutic relationships. On the other hand, clients benefited when their therapists helped them navigate the transition process by supporting and affirming their identities and autonomy.

No abstract

Students in counseling psychology have cited a desire for more opportunities to engage in social justice within their programs. Pressing national issues, such as homelessness, offer an opportunity to use transferrable psychology skills, including consultation, to address and prevent systemic oppression, while affording students necessary training. This paper describes a doctoral level counseling psychology course on social justice consultation and evaluation. The students and faculty undertook a consultation project with the city’s Office of Homelessness Prevention and Intervention (OHPI), where they applied a strengths-based social justice consultation model to the goal of providing recommendations to prevent homelessness. First, we set the context for homelessness in the United States and [university town]. We then outline the data consultation process and preparation/presentation of a formal report for OHPI officials, including successful outcomes from the consultation. Finally, we discuss lessons learned from the consultation project and recommendations for students and faculty who plan to implement social justice consultation into their graduate programs.

No abstract