Clinical Round Table 10 - Leveraging Gender-affirming CBT Against the Impact of Structural Transphobia: Optimizing the Translation of Evidence-based and Ethical Practice in Contexts Restricting Gender-affirming Care

The primary goals of this clinical roundtable are to discuss the cumulative burden of gender minority stress on transgender and gender diverse (TGD) individuals across the lifespan, and to describe the utility of gender-affirming cognitive-behavioral therapy (CBT) in reducing adverse mental health outcomes among TGD youth and adults who experience minority stressors. TGD populations are at least two times more likely to experience depressive episodes, seriously contemplate suicide, and attempt suicide in the past year compared to their cisgender peers. These mental health disparities are partially attributed to gender minority stress and expected to grow in response to the rapid changes in legislation affecting TGD individuals. Clinicians are likely to see an increase in the cases of TGD clients experiencing clinical concerns related to structural transphobia. The principles and techniques of CBT are well-suited to target mental health symptoms exacerbated by gender minority stress, including structural transphobia. However, if not delivered within a gender-affirming framework, CBT clinicians may risk invalidating client experiences and reinforcing distress and vulnerability. Leveraging models, research, and clinical experience in the provision of gender-affirming CBT across the lifespan, the panelists will discuss evidence-based implementation of principles and techniques best positioned to address the clinical sequelae of structural transphobia. Discussion of clinical vignettes representing real-world clients with presenting concerns related to structural transphobia will support real-world applications of gender-affirming CBT in the current sociopolitical context. Finally, panelists will discuss the ethical prerogative of clinical psychologists to continue providing gender-affirming therapy in the face of emerging federal policies based on scientifically unjustifiable claims that such care promotes “gender ideology,” exploring potential solutions to care barriers.