Sara Bravo-Peterec: and I will go ahead and introduce today's
speaker, very important subject, so Dr. Megan Gandy is a professor in the WVU School of Social
Work and is the BSW program director she has a diverse career spanning clinical advocacy and
research work over 10 plus years each with a background in clinical practice and activism she
engages actively in social justice initiatives her primary research focuses on LGBTQ+ wellbeing
from community level factors to practitioner competency
and Faith Community Support Dr. Gandy's
teaching philosophy prioritizes student- centered approaches transformative learning and teaching
integration and I will go ahead and turn that over to Dr. Gandy Dr. Megan Gandy: Wonderful thank you Sara I appreciate it and thank you all for showing up today, I'm really excited to be talking with you about this topic um so let's get into it. One of the things that I'm going to ask is for you to
just fill out a poll um this poll just asks you generally
have you had any experience with this kind of training before and then also what are you hoping for the most if you had to choose one of these different topics that we could cover today and the reason I'm asking that is because I have way more slides than I could actually present in an hour and so I wanted to provide you with that information so you'll have it on the handout but I really want to focus our time together on the topics that um you're really most interested in so um while you're fil
ling out that poll just
introduce myself a little bit more um as Sara said um I have a diverse experience uh with
clinical experience, mostly in mental health treatment uh both in the community and in um psychiatric hospitals uh settings um I've also been a researcher and educator um for over 10 years, about 12 years now, uh focusing on LGBTQ+ people's well-being and one of the things
that I've done throughout my career is advocacy and activism and I've done that in four different states basi
cally every state that I've lived in um all of them have been uh in the South some of them have been very rural and so I'm excited to bring um all of this together to talk about this topic with you today so let's see it looks like we've got about 73% of you have completed the poll um so so far we're split even on whether or not you've uh attended a training like this
before and then we're also kind of split pretty evenly on the basics versus advocacy um see if anybody else has time to complete
the poll here got a couple more people participating so I'll go ahead and end it so that you can see the results so um that that's really helpful for me to know so I think what we'll do is kind of spend some time on some of the basics and uh throughout the basics
I will be touching on a good bit of advocacy in mythbuster um information the one thing that I
don't have for you today is stories specifically from trans and gender diverse people uh but I
did just want to assess your interest in th
at so that I could do that um in future sessions and so
um this is kind of what we'll be doing today just um the basics um and then also some best practices
and we'll be talking a lot about medical care for this population um and then we'll end it with some
discussion of what happened in the West Virginia legislature this year so um what we have uh next
is a little title slide all right moving on okay so um this is just kind of a thought experiment
you don't have to answer this in the chat
um but just ask yourself do you have a affirming
flag or sign in your waiting room, office area whatever it is that you work within and if not,
why not? the reason that I ask that is uh um just because it's really important to provide a visible
sign of not just uh welcome but true affirmation for this population and we'll get into more
about why that is in a few minutes so just kind of starting from the
beginning um gender affirming care so that's this um acronym of GAC or G A C uh the Worl
d
Health Organization defines it as any single or combination number of social, psychological, behavioral or medical interventions which include hormone treatment or surgery that are designed to support and affirm an individual's gender identity so we'll get into a little bit
more about what all of these different aspects are what are the social aspects, psychological
aspects, Behavior or medical aspects, and we'll talk about that in more detail here soon uh but
the real burning question tha
t I think needs to be answered is do you have to have quote
unquote gender dysphoria uh in order to need gender affirming care and the short answer
is no uh because simply being transgender or gender diverse in any way is a matter of
diversity, not pathology, and that is certainly an understanding that has evolved over the last 50 years um gender dysphoria and other gender related diagnoses were in the DSM in earlier uh
versions of the DSM um but today we focus more on the distress that is c
aused by people who
are dealing with the effects of their gender um their gender difference or the transition
that they might want to go through and so I think it's important realize this because there are people that undergo gender affirming care that may never need psychological or social care um they may have a very perfect understanding of who they are they're very un unbothered by
it and they are simply looking to transition and I think that that is something that is important for us to
recognize that gender uh diversity is diversity not pathology um however recent laws have started to contradict this understanding and we'll see that more with minors um
as we look at some specific West Virginia legislature and so we'll look at um some West Virginia legislation that happened last year and we'll also talk briefly about how health insurance policies contradict this understanding so uh as last year you may have heard about uh West Virginia House Bill 2007 um that was a passed Bill
and it essentially prohibited gender affirming
care for anyone under the age of 18, however there is a carveout uh exception for that prohibition uh which basically says if the person has severe gender dysphoria then they are allowed under law to have care. now this kind of contradicts our understanding of why or what would an adolescent need in order to affirm their gender and so it's really troubling that uh the law really dictates or is trying to dictate what it is that um young people need
to do or say in order to get treatment they must um meet criteria for this severe gender dysphoria in order to be allowed to access medical
treatment now that doesn't include other types of treatment it only um relates to medical treatment
which we'll talk about in a minute but essentially what does that mean for you as social workers? that
means that um you can still refer your adolescent clients to Specialists for assessment and we'll
talk about who those Specialists are and you can conti
nue to provide um counseling assistance
psychological treatment and just general support for trans and gender diverse minors and their
families and so we'll talk a bit more about the clinics that offer medical gender affirming
care um but essentially your work with trans and gender diverse adolescents and their families
will continue as um as we'll see in the next few slides and so another thing that really
contradicts our understanding of gender affirming care is health insurance policies
so
health insurance policies for both minors and adults usually have uh an expectation that a
person needs a quote unquote letter um or they need quote unquote permission or assessment or
evaluation from a mental health clinician and those requirements come from uh what's called
The WPATH SOC (Standards of Care) WPATH stands for the World Professional Association of Transgender
Health and uh so essentially the standards of care outline what it is that a person would need to
what criteria t
hey would need to meet in order to qualify for gender affirming care now that
itself is kind of a contradiction with another model which we are seeing much more prevalent
today which is the informed consent model the informed consent model is basically what you
do with any kind of health issue with your doctor. your doctor tells you that you go to your
doctor for a problem your doctor tells you their understanding of the problem and their treatment
options and then discusses the benefits an
d the risks of the treatment options and then you can
decide for yourself whether or not the benefits outweigh the risks so that informed consent
model is used for all other health care but it's not used for gender affirming care and so
that's why we're really encouraging Healthcare Providers to adopt the informed consent model
because again gender diversity is not a matter of pathology it's a matter of diversity um and we
will talk a bit more about the informed consent model in a minute um
but one thing uh to know
about uh clients that are receiving Medicaid from West Virginia um there was a lawsuit um
basically that alleged that people that were receiving Medicaid in West Virginia were
excluded from care for their gender affirmation or gender dysphoria and so fortunately we did
win that lawsuit um Lambda legal was the uh main provider of legal services and the the
court case was this Fain vs Crouch and so what that means is that yes your clients should
be able to access ge
nder affirmation and gender dysphoria care however the reality is getting a
provider who accepts Medicaid who is up to date on their knowledge of gender affirming care
is more of a challenge and that's why it's a good idea just to refer that person to uh one of
the clinics regardless of their insurance status because the clinics will help them navigate
uh and figure out a provider that is um affirming and so um I think it's important to
note that gender affirming care is an ethical imperati
ve um social workers are obligated
to uphold NASW code of ethics and right now um luck we're very grateful that we don't have
any legislation that bars social workers from providing gender affirming care but there are
other states that do have that and so I have um this Open Access resource that's created
by Veronica Timbers that just kind of walks through what are the ethical responsibilities
that we have to clients and it actually also touches on other disciplines as well marriage
and fa
mily therapists, uh licensed professional counselors, so um that's a a nice Open Access
resource you can use and also just to note that NASW is very clear uh on their stance that
gender affirming care saves lives um and so we should keep that in the Forefront of our mind
as we're working with this population so let's dig a little bit deeper into gender affirming
care and especially medical gender affirming care for minors so what does gender affirming
care look like for minors uh first of a
ll you should know that it's always an individualized
course of treatment so uh we're definitely not going to suggest the same psychological or
medical treatment for one individual as we do for another individual because everyone is
very different in their Journey and so that's the first thing to know the second thing to know
is that this treatment is lifesaving I probably don't have to tell you about the rates of suicide
attempt, um suicide completion, um mental health struggles, substance
abuse struggles, as well as um
social and support struggles that trans and gender diverse people have and so the research is very
clear that when minors receive gender affirming care whether it's social, relational, legal or
medical that all of that care contributes to a better quality of life and really does help save
the lives of gender diverse people so this is really important stuff that we're doing
and so what you as a social worker can provide um you can always provide family support
for minors
um families that are wrestling with the issue of their child navigating their gender journey um you
can also help them navigate the school system and how they deal with the child's presentation at school um you can also help navigate help them navigate relationships with other family members um other types of relationships like um churches or faith communities um people, families really
need that kind of support and then of course there is individual and family therapy that you ca
n
provide uh and then you can also refer for medical evaluation and we'll talk a bit more about what
that looks like so essentially gender affirming Medical Care comes in two different categories for minors if they are before puberty so that's you know anywhere up to 10, 11, 12 years of age um
then they do not get any kind of medical care at all because they don't need it they haven't gone
through puberty and so um you'll see basically supportive counseling, individual or family
therapy as
needed and also just that assistance that I talked about and then after puberty that
counseling continues so it's not just like okay you've hit puberty let's get you on hormones um
it's definitely a continual support process and then the person at least in West Virginia would
be evaluated for severe gender dysphoria and that is what would prompt medical treatment um and
we'll talk talk a bit more about what that medical treatment looks like and so medical treatment
may be needed it may not
be needed um and then other kinds of counseling to help that young
person and their family through their gender journey and so essentially the two medical
treatment options for minors after puberty uh one option is puberty blockers so these are
medications that have been used for decades uh for young people uh traditionally they've been
used for young people who have started puberty much much earlier than they should have um and
so that it essentially delays puberty and so that has been use
d with gender diverse young
people by essentially buying them some more time helping them think more about their gender journey, help their family work out issues um and then just kind of continue to evaluate that gender dysphoria so once that child hits puberty that's when those secondary sex characteristics can start to develop and that's really when you start to see more dysphoria um that can develop and so if that's the case puberty blockers are a great way to help that young person and the
ir family navigate what's going to be best for them moving forward and then some people do the puberty blocker but some of them may just go straight to hormone replacement therapy um it is common to do a puberty blocker regardless uh but it's not entirely uh only the case so hormone
replacement therapy uh you may be familiar with this with other medical diagnoses specifically things like uh menstrual issues or um menopause issues and so we use that same kind of hormone replacement therapy for u
h gender diverse young people when the time is right and so um just
like any other medical procedure this process is supervised by uh a team of medical people actually we'll talk about that in a second and there's never a time that medical treatment
is given to these minors without parental consent and so let's pause for a minute and
think is this safe? is this something that's safe for these young people? um the first thing to know is that puberty blockers aren't permanent um puberty blocker
s are completely reversible and
so a young person could be on a puberty blocker, give them more time, and then if they end up going
off of it and deciding they're going to continue their Journey without transition or without
medical transition then they just continue to live their lives um and even if they do move on
to hormone treatment there's there's no negative indications for puberty blockers um another thing
to know is that medications are never initiated until after that minor has be
gun puberty
so there's some misinformation out there about surgeries happening or or other medications being
given to Children um and that's never happening uh before puberty the other thing to know is that
all of this treatment is um highly scrutinized by uh various scientific uh groups and has been
um supported by every major medical and mental health organization um so that's American
Association of Pediatrics, American Medical Association, um American Psychological Association,
and NAS
W so it's this kind of treatment is is very well supported with good good evidence um
another thing to note you know when we're thinking about medical treatment we think "do the risks outweigh the benefits?" and with some gender diverse minors we clearly see that the benefit
is going to outweigh any risks that they may face and that usually comes with lower odds
of um depression and suicide specifically uh 73% of minors um have lower odds of suicide when
they have gender affirming care I thi
nk that says a lot about the impact this treatment can have
and so of course um any medical treatment comes with risks and uh their provider should be the
one that they're talking about those risks and benefits with not a legislator um and so it's really
frustrating I think for parents to see that they have to undergo this special scrutiny just to get
their child the medical treatment that they might need and so this is kind of the advocacy bit
that you might use if you're encountering some
misinformation um and especially in West Virginia
there was a lot of misinformation shared when the law uh the the bill was going up for
consideration last year and this year as well um but essentially medical care for minors is not
surgery we do not do surgery for gender affirming care for children under the age of 18 in West
Virginia um it's also not irreversible in terms of puberty blockers it's also not sterilization that
that term has been used in some discourse uh there are fertility
impacts if the child does go on to
take hormone replacement therapy but those impacts are fully talked about and worked through with
the family there are uh fertility uh treatment uh uh fertility uh saving options I forget the
word right now i'm sure somebody else can drop it in the chat uh so yeah so the the
risks and the benefits for fertility are discussed with the parent um um and the children before they
proceed with anything that could impact fertility um medical treatment is not gen
der affirming uh
is not provided to pre pre pubertal that children um and also it's simply medical treatment is not
provided without all consenting legal Guardians um and so that may have been a concern that you've
heard of um but at at least at the clinics that I'll talk about um they do not accept any just
one parent to consent they require both parents to consent to the medical treatment which
is the case with any other kind of medical treatment um and so what are the um consequences
of
banning care for minors so we have the uh possibility for the suicide attempts and
completions and in West Virginia this is a very serious issue um because uh in a study in
2022 they found that 14% of transgender youth in West Virginia did attempt suicide and 60%
of them seriously considered suicide there's also the possibility for severe impairment
uh so severe impairment can come from that depression or that suicide attempt um and
as we can see gender affirming care really lowers those o
dds uh we also see severe psycho social outcomes um we see that coming parents are very concerned parents of of gender diverse
young people are overwhelmingly fearful that their child's mental health would be negatively
impacted um and they may attempt suicide just as a result of these gender affirming care bans
and so that's certainly the case with um the ban here in West Virginia and essentially
the consequences of these bans are truly devastating um every US state that has a gender
affir
ming care ban um has found that providers are strongly opposed to those care bans and
that there's a fear um of severe consequences to the health of transgender youth so we can
see that the consequences are really severe here and that's why we really need access to
gender affirming care for minors um I do see a question in the chat do both parents need to
consent to treatment if one of them lost custody so the answer to that is if that parent who lost
custody would still have the right to c
onsent to treatment then yes any kind of treatment medical care in general but if they've lost the legal permission to consent to medical treatment
for their child then no they would not be required uh so here comes some of those
MythBusters and I've kind of these are kind of reiterated from other slides but you
know we're talking about surgeries there's no surgeries happening in West Virginia on
minors um for gender affirming care um there's no treat there's no medical interventions at
all
for children that are pre pre puberty uh puberty blockers are fully reversible and
any risks that may come in in line with those are discussed fully with the parent and the child- parents and the child before they initiate that um and then we're also getting consent from parents
whenever we do initiate this medical treatment so that brings up uh this another Hot Topic
issue uh which is the idea of transition and so that's what some of the uh anti-gender affirming care um voices talk about- h
ey there are people who regret doing this and so we should ban care
for everyone because there is a small number of people that regret doing the irreversible parts
of gender affirming care and so I definitely want to address that I think that's really important
um so first of all you think about medical care that you encounter I know for example people
who have mastectomies um and reconstruction um the people who have that kind of surgical care
sometimes they're really not happy and sometim
es they regret doing it and sometimes they wish they
never did it even if they had to do it for cancer or other reasons that's a life-changing surgical
procedure and so if the dissatisfaction or regret after something that we we feel is commonplace
for people with breasts then we could also expect that there's some regret uh over medical
care for gender affirming care as well um but the truth of it is it's extremely rare because
medical providers are doing such a good job of screening peopl
e and really assessing their need
for gender affirming Medical Care and so we see as a result that there's very very few people
there's a study in that was published in 2022 that found that it was only about 2% of people
decided to detransition or or basically go back to the gender that they were assigned at birth
um and we also see that regret is also very rare another study found that there was only 0.3% of
individuals in that study were regretting the care that they got so if you think a
bout that
on the other end 98% of people are happy with the care that they got how often do you get
98% of people to be happy about anything so it's very clear that gender affirming care when
it doesn't work out for someone is obviously a concern and that's something that that person
should discuss with their medical providers but that's not a reason to ban care for everyone and
then another important aspect of de-transition is the fact that a lot of people de-transition
not because it was
n't right for them but because they had so much discrimination that
they faced that they decided that it would be less of a disruption in their life if they just
decided to not take their gender affirming care anymore um and so that's certainly something
that's heartbreaking and something that we can work on in terms of the stigma and the the
advocacy that we need to do for gender diverse people and so now we get to the process for gender
affirming Care Medical gender affirming care for min
ors in West Virginia so there's two clinics
in West Virginia that provide this service um there will be more um one more provider in the
southern part of the State uh but for now you have um uh WVU Medicine which is located in
Morgantown they have their Clinic once a week and so if you refer to that clinic your client
will probably be seen pretty quickly. Marshall University uh their Clinic only happens once a month um and so they will certainly be seen but it may take a little more time and
so this is
not just one single doctor helping the families make this decision this is a pediatrician, this
is mental health clinicians plural um this is all the legal Guardians involved in Minor's care
and the whole team evaluates this child over time for what kind of medical treatment they might need
it's not simply one person making this decision. I think that's really important because it shows
that this this is taken very seriously and um taken a lot of care and consideration by all of
the professionals involved and so when should you refer a client to this clinic, maybe basically, as soon as the family is open to it. so the child can be below uh puberty before puberty and they
can still benefit from talking to the um Clinic because the clinic will assess the child and
will continue to be in communication with the family because puberty blockers will begin
at the point at a certain stage of puberty development and so the if you're encountering
child that's pre puberty th
en you can go ahead and still um refer them to the clinic um and
another thing that the clinic is really good at is they're really good at triaging so if you
have somebody who's really high severity and high need and needs to be seen immediately they're
going to triage that person higher than the client who um maybe they don't they're pre-puberty and
they're not ready to go on to medical treatment yet so they essentially are able to triage where
people might be need needed to be seen um so
yeah any age is okay and the family can be at any point
in the process also the family may say oh I'm not really sure if this is right for my child or
not um they can talk to the clinic um as well as any any family that's at any other stage of
uh their decision-making process and so the best way to get in touch with um the clinics is
through transhealth@wvumedicine.org um and that goes to a specific person who will help direct
you to the clinic that's best for your client and other kinds of
options that your client may
need so that's the email that you want to write down um and so of course there's other kinds of
support in West Virginia there's family groups um there's a PLAG in Fairmont there's a
online group called raising trans kids in Morgantown there's other support
groups in the southern part of the State um you can go on to the fairness West
Virginia website and find those connections there's also um One online Facebook group
in particular that's helpful for parents
is called trans parent allies um and that is it's
not a therapeutic group but it is moderated by a clinician and so it's a good place to go
um for people that might look for that online support. So what is it that social workers
really need to do most with their families and their minors at this time? Just provide
that non-judgmental support and know that it's a journey not a destination that goes
for any age trans or gender diverse person that um they their Journey they need you to
walk a
longside them with a non-judgmental stance so um giving that we have some we we've
got about 15, 20 minutes left so I'll kind of go through this quickly so we have time for questions
um so we're moving on to adults medical treatment for adults that uh again some adults may not want
any of this they may want to socially transition or legally transition and never need medical
care um but for those that do there is that hormone replacement therapy um and then there's
also various gender affirm
ing surgeries um that will make surgery possible but people commonly
refer to Top surgery um which is the chest region and bottom surgery which is the genital region but there's also other surgeries that are gender affirming um such as facial contouring and
other body contouring surgeries so those are all possibilities and there's also voice therapy
that um adults may choose to go through um it basically helps if they're concerned about um
having a voice that matches uh perceptions of the ge
nder that they are presenting as then it
will help them lower or raise their voice um more consistently and so I I want to talk for a minute
about um what is what is your role as a social worker with adults as they're going through this
process um and what are kind of the the struggles of trans and also queer people both in healthcare
and in therapy so um one of the first things to know is that your trans clients are coming into
any health care or therapeutic relationship expecting it to be
difficult they're expecting
to have to educate you or they're expecting to have to experience some transphobia so as much
as you can to um eliminate that possibility is definitely going to be appreciated by your trans
and queer patients um there's also this idea of this double bind that adults especially face because
uh we know this expectation by health insurance companies to say you have to get a letter, you
have to have a year of therapy, for example, and then you have to have a letter
from your provider
um and so it kind of puts the trans person in this position to say that I'm sick enough that you have
to validate my care but I'm not sick because this is normal right if this is a normal way to be
then am I sick or not so it puts them in this double bind and the patients the trans patients
have to walk this line of okay am I sick or not am I needing your your stamp of approval or your
support and it really prevents that authentic connection from happening and it prevents
a true
therapeutic relationship and it it therefore kind of prevents trans people from really getting the
benefit out of therapy and supportive counseling that they could get and so what is it that you can
do to help minimize or eliminate that double bind um you address it directly use very explicit
language say are you here for a letter or are you here for support I can write you a letter
that's no problem just simply saying that will immediately uh dispel some of the fears that your
tra
ns patient your trans client has because they know that they don't have to present this sick
model of themselves in order to get your buy-in to write a letter they can then actually switch
gears and start to be more authentic about what are their concerns about it what are their um
what kind of support do they need and so that goes that's more in alignment with the informed
consent model for adults, basically you know yourself, you know the risks and benefits and I'm just here to support you
in making that decision um that is very contradictory to what
um health insurance policies ask us to do but um you are in charge of your own therapeutic um
experience your own therapeutic relationship building and so you do get the chance to
change that expectation um for your adult clients and so something to kind of help you
think about what uh how you might how a trans patient might be feeling um when they have to
come to you to get that letter um have you ever had a health condition th
at required treatment think about that for a second and then how did you navigate that decision: so who was there for you? did you go and do research? did you talk to multiple doctors? did you talk to your
family? um what are the things that you did to really help you make that decision- those are
the things that trans and people do as well especially trans people when they're considering
medical treatment and so they don't need another hoop to jump through to get to that care
they need your
support and the reality is trans people in particular are facing lots of
different challenges finding support in their lives trans people may have been um rejected
by their family rejected by their loved ones they may not have the kind of support that
they would need to go through any kind of Health situation much less gender affirming
care and so knowing that it's important that we as social workers can be that supportive
person for trans adults as they go through their journey and so jus
t kind of reinforcing this
idea of gatekeeping and why it's so um harmful um to the relationship essentially if you are
there to say I'm going to assess your readiness for gender affirming care then you've already
lost a lot of the therapeutic relationship that you might have with your trans client because
it makes real therapy inaccessible so instead you should be explicitly transparent if you
need a letter, I'll give you a letter. If you feel like the person isn't ready for gender
affirm
ing care maybe ask yourself is it is it that their Psychopathology is being further
triggered by their gender not being uh in alignment with their gender identity maybe
that's the case and often that is the case the person they might not feel ready to you
but they are ready and the only thing holding them back is the lack of gender affirming care
their body is essentially creating this kind of dysphoria and so we actually see that a lot
that therapists kind of hold back on giving that lette
r and that's where the gatekeeping is
that we see and and um the reality is there's so many trans and gender diverse people that
are very familiar with all of the risks and benefits and they know themselves they've known
themselves for years and they're ready to get the treatment um and so jumping through these
hoops is um really hindering that therapeutic relationship and so the model that I present
to you today is the model of Journey supporter Basically how do you help uh your trans
cli
ent go through their Journey you want to make sure you're flagging for safety that just
basically means you're giving those implicit and explicit flags that say I'm not going to
gatekeep you I'm not going to say that I know yourself better than you do so again that's
where you say you need a letter I'll write you a letter what do you do you need support
I'll provide you with the support but really relying on that informed consent that adults are
aware of the risks and benefits of treatment
um and so I I really want to encourage you all to to
consider that model because it's important for Trans adults especially um I have one story of a trans person uh he was in his 40s when no he was in his 30s when he moved to West Virginia and he had been on hormone treatment for 15 years uh presenting as a man in public and fully living his life as a man um he changed over to insurance that was covered by his employer here in West Virginia and of course that insurance company said um well you'
re a new client and we
expect that all of our patients will go through one year of therapy before they get gender
hormones gender affirming hormones so here this guy was he's in his 30s he's lived his life
as a man and he's facing having to go off of his hormones for the first time in his adult life just
because an insurance company said well these are the rules and so that person actually had to
go out of state and pay out of pocket to get their hormone treatment and it's just a barrier it
's a barrier that shouldn't be there um and it's a barrier that is really detrimental to our
trans um and gender diverse patients and so um as much as you can to um break down those barriers
that will be really meaningful to your trans patients. all right so really quickly here we'll
kind of fly through the West Virginia legislation uh 2024 so West Virginia legislation in 2024
over 20 bills uh were introduced that are were targeting LGBTQ+ populations however most
of those did focus on tran
s and gender diverse citizens um luckily only one bill did become law
this session um so that's the one that we'll talk about in a second um so essentially that bill in
my opinion is legislating an imaginary situation because the bill is legislating something
that doesn't happen in West Virginia so um it essentially relates to gender markers on
birth certificates currently West Virginia does not offer non-binary gender markers on birth
certificates but um the bill sponsor Republican delegat
e Chris Pritt um said he wanted to make
sure that the state didn't start offering that option in the future and so um he was essentially
legislating something that doesn't happen um and so that just becomes you know one more barrier
to living their authentic lives that trans and gender diverse people have here in West Virginia
um so um it's a shame that this law was passed um but at the same time there were some really
harmful laws and bills out there that were introduced and um I for one a
m grateful that those
laws did not continue through however um the fight isn't over there are more bills that could
come up um basically even though the legislative session ended on March 9th um the legislators can
introduce a bill during special sessions um that's what we saw happen in the um abortion access situation um so essentially the legislators were called to um a special session to address the budget and instead they addressed abortion access and so we could see that happen in 2024
if there are special sessions there typically are special sessions that happen so keep your eye
out for if those things happen and of course these bills will come up um in um 2025 and beyond so if
you want to have information about where to find action alerts then you can follow fairness West Virginia, ACLU West Virginia, and NASW West Virginia those are some good starting points for how to
get that information and I see your question in the chat we'll get to that in just a second um
so I ju
st kind of want to end the conversation again asking yourself do you use this
unequivocal language of support and do you have those visible signs of acceptance and if not then
you definitely need to reconsider doing that um because it makes a big difference for trans and
gender diverse people and people all across the LGBTQ+ spectrum um but don't stop there trans
and queer folks need more than that they need you to support them all across their Journey so that's
my my call to you all today
all right I think we actually made it through all my slides so yeah um
I see one question in the chat um I'm wondering if a group of intersex West Virginians could lobby for the non-binary option for birth certificates and actually be listened to by legislators that's a great
question um I don't know the answer to that but I think the first step could be to reach
out to some of these lobbying groups um ACLU, Fairness WV, uh NASW um and just kind of talk
through what would the strategy be tha
t which of the legislators would listen and that kind of
thing because you're right um non non-binary option on birth certificates is really important um and
so I'd love to see that happen in our state uh other questions? I got references I'll stop
sharing my screen so it's easier Zoom participant: I had a question, oh sorry um, I think I got lost in
the chat um I was curious what the um evaluation process looks like for determining if someone
has severe gender dysphoria Dr. Megan Gandy: Ye
ah that's a a great question um so because it is individualized
there's not a set number of sessions or a set number of meetings um but essentially um the minor and their family would go meet with a pediatrician um and from there they would kind of plan out their their game plan so there would be individual sessions with the minor there would be individual sessions with parents uh and any other family members or other people that might be relevant um and then um the team would come together and
kind of assess where the person's at, what else they might need, um and then go from there about what recommendations they would make and they may do
more than one they probably will do more than one assessment. Other questions? Zoom participant: I had to step out for a little bit um so if this was already in the presentation please forgive me but is there an evidence-based
curriculum just curriculum you would recommend for people wanting to start support groups
like for people of let's say
like teenage demographic Dr. Megan Gandy: Hm, that's a a great question um I don't have one off the top of my head but I could do some research and get back to you on that Zoom participant: I would I would love that because I uh would hate to try to spark something up
without the right kind of uh footholding Dr. Megan Gandy: Yeah that's understandable if you want to email
me um you can send that same question to me and then I can look at what's out there and give
you an answer Zoom participan
t: Absolutely thank you Dr. Megan Gandy: Yeah, you're welcome! "Any suggestions on addressing reluctance
of high school personnel refusing to use names and pronouns?" Yeah this is a great question um you
know one of the things I don't know that this is a good idea but um I'm talking off the cuff but I've
always wondered what these people would do if we um specifically misgendered them so you know you
have a male um principal and you said "Hi she, her" you know and really just misgendered him
a lot
then they might understand the importance of not misgendering their teenage their their high schoolers. I'm not recommending that, it's just a curiosity, if you do end up trying that let me know how it goes but we probably shouldn't be in the practice of um intentionally misgendering people but um um you know I think one of the things we can do is present these um MythBusters to the uh High School Personnel um just to help them understand that you know these are things that um the trans
or gender diverse team really needs support in and we know that the more supportive people in even one supportive person in a trans teens's life can make a huge difference um
and just kind of um eliciting that desire to make a positive difference in their teen's
life might help um do we have other folks that have had experience or success in getting um High
School Personnel on board using names and pronouns I don't hear anybody coming out immediately but yeah I think trainings like this can h
elp all School Personnel yeah and
I think the more you focus on those kind of Mis misperceptions or MythBusters
is good because we know that the media is ripe and full of all of those Mis um
misconceptions, misinformation um so the more you can um put in your toolbox
those specific MythBusters the better it is Anybody else facing any uh practice issues that they could use some support on with
working with trans and gender diverse people? Well one thing to know if you are
planning on attend
ing the WV NASW conference uh in April which you should consider it if you
haven't um I will be providing the same training there so if you attended this one then that means
you're free to attend a different session at the conference um and also if you know somebody who
missed this one you can definitely tell them that I'll be presenting the same information at
the conference and I hope to see you there I'll be at the um WVU table here and there so if you
see me there come up and say hi lov
e to talk to you
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