Transgender Training - ITCA Curriculum 2020

Transgender Care Certification Program 52 Hours - March & May 2020

    Part 1 Class Learning Objectives
Day 1  



Volker &


TGC 701 Foundations of Transgender Care

Introduction and Orientation

Describe program process w/needs assessment
1. Lack of knowledgeable service providers
2. Need for personal counseling
3. Need for letters of recommendation from experts
4. Support & education for family, friends, and employers


  1. Describe the role of the mental health professional in working with the transgender population.



Volker & Lam

Lectures-Bio roles/ Orientation

1. Categories of Identity
  a. Biological sex
  b. Gender identity
  c. Gender roles
  d. Sexual Orientation
2. Transgender umbrella
  a. Cross-dressers
  b. Transvestites
  c. Female Impersonators
    i. for entertainment
    ii. for income
  d. Transsexuals
  e. Intersex

1. Define the major categories and subcategories of identity related to sex and gender
2. Distinguish a fetishist from a transsexual or cross-dresser.
3. Identify and distinguish problematic and defamatory terms in referring to a gender non-conforming person.


Volker & Lam

Transition Decisions


   I’m different

   Identifies as transgender

   Reach out




Coming out

Family & Friends


How far to go?





  1. Describe the stages of transition
  2. Describe the secisions trans people need to make

General Panel Presentation

Trans individuals will discuss the transition process, including

  1. The Question of “Who Am I?” – Exploration of Gender (non-conforming) & Sexuality 
  2. Process of transitioning 
  3. “Presenting” & “Passing” 
  4. Coming Out 
  5. Private Life, ongoing
  6. Work
  7. The clinician’s role.
  1. Integrate the previous didactic learning wiht the real life experiences of trans people.
  2. Discuss the challenges trans people face in various life areas.
12:30pm-1:30pm Lunch break w/ panel members  


Batista, Clark, & Lam

Debrief regarding Panel Members

The Transition Process

Overview of Motivational Enhancement Stages of Change

  1. Mental Health Evaluation and Therapy
  2. Hair Removal
  3. HormoneTherapy
  4. Genital Reconstruction Surgery
  1. Vaginoplasty
  2. Phalloplasty
  3. Labioplasty
  4. Metoidioplasty
  5. Chest Reconstruction
  1. Facial Feminization Surgery
  2. Voice Therapy
  3. Decisions
  1. Name Change
  2. Relationships
  3. Employment
  4. Reproduction


  1. Describe the stages of transition from a Motivational Therapy perspective. Discuss various paths each person may take. 
  2. Assist an individual in each stage of the coming out process
  3. Describe the various changes available for transition.
Day 2  

TGC 702 Transition Challenges


Facial hair and binding

Coming out, initial and ongoing

Body changes

Finding providers





  1. Describe in depth the challenges faced by trans people.
  2. Implement role-play with transitioning clients to help them deal with various situations.
  3. Discuss the therapist's role related to the specific challenges.
12:00pm-1:00pm Lunch  
  1. Transition Challenges (cont.) 
  2. Legal - Overview
  1. Documentation
  2. Marriage
  3. Divorce
  4. Custody
  5. Work 
  6. Accommodations
  7. Sensitivity

3. Relationships - Intimacy

  1. Family 

Differentiate the trans person’s needs from others

Changing roles



Family needs support and validation

b. Friends

4. Cultural Wheel

  1. Describe the legal aspects of transition
  2. Describe the relational aspects of transition
  3. Describe the obstacles to medical care and treatment
  4. Recognize those particular challenges faced by transgender individual from various cultures and countries.
Day 3  



Batista & Clark

TGC 703 Evaluation, Assesment, & Differential Diagnoses

The WPATH Standards of Care

  1. Intentions of the Standards of Care  -overview 
  2. Hormones & Surgery
  3. Expectations
  4. Preparation for changes


DSM 5:

  1. Describe the intention of the Standands of Car (SOC)
  2. Implement th SOC guidelines for transition
10:00am- 12:00pm

How to do and Evaluation:

Assessmnets and recommendations for clients

Areas of remediation

  1. Implemnent assessment and therapuetic strategies to assist trans peoplewith transition planning


12:00pm - 1:00pm Lunch  

1:00pm- 5:00pm

Volker, Lam & Batista

Areas of remediation

  • Trauma
  • Suicide Prevention
  • Addictions - Addiction 101

Religion & Spirituality 

  1. Orthodox Jews
  2. Christianity - Conservative
  3. Muslim case studies

(potential Guest)

  1. Assess for those areas that need to be addressed prior to recommendations.
  2. Determine the relevant areas to be targeted in therapy.
  3. Utilize a variety of assessment tools. 
  4. Demonstrate ability to conduct an evaluation interview. 
 3/8 Day 4  

9:00am - 10:00 am

Lam & Volker

TGC 705A Transition through the Lifespan 1: Child and Adolescent Care

Children & Families of Trans People Panel Members

  1. Medical Intervention 
  2. Family & School


  1. Describe the basic challenges a family faces
  2. Develop intervention strategies appropriate for various family members.
  3. Describe and define the various terms used by the younger generation of gender non-conforming people.
  4. Distinguish issues specific to children and adolescents from adults regarding gender identification and transition
  5. Use an understanding of trans people’s and family’s    experiences to develop individualized transition plans.


10:00am - 12:00

Children & Families of Trans People Panel Members

12:00-1:00pm Lunch  

SOOFAS – Workshop 

  • Breakout Groups
  • Discussion 


Part 2 Class Learning Objectives
Day 5   
9:00am - 12:00pm

TGC 706 Treatment Planning & Therapeutic Issues

History Timeline and Review 

  • Cultural Competency
  • Review Transgender Umbrella and additional terminology

Letters of Recommendation

Letters of Support

  1. Travel
  2. Work
  3. School


  1. Implement a transition treatment plan.
  2. Write effective recommendation letters for hormones and surgeries as per SOC guidelines
12:00pm - 1:00pm Lunch   

1:00pm - 2:00pm

Clark, Batista, Volker, & Lam

TGC 705B Transition through the Lifespan 2: Senior Care

Transgender Senior Panel

  1. Prolonged effects of hormone therapy.
  2. Loss of families and/or social supports.
  3. Dealing with healthcare providers.

 Group Activities 

Assessments and 

Writing letter of recommendations

Role Play Exercises 
  1. Describe those issues specific to older adults in transition.
  2. Describe issues likely to arise for transgender people in their senior years.
 2:00pm - 5:00pm Consolidation and Processing
  1. Discuss the discrimination trans people face in the environment
  2. Describe the basic challenges a family faces
  3. Describe the etiology of the addictive process
  4. Compare and contrast the different attitudes towards trans people in various cultures
  5. Describe the impact of religion on transition
  6. Recognize the restrictions against transgender people in jails and prisons
 5/8 Day 6  
9:00am - 12:00pm

TGC 704A Medical Interventions 1 - Hormones

Hormone Therapy

Hormone Management 

Describe the hormone therapy protocols.

2 .Describe primary and side effects of hormone therapy.

12:00pm - 1:00pm Lunch  
1:00pm - 4:00pm

TGC 704B Medical Interventions 2 - Surgeries

Guest Speaker

List and describe the various medical interventions for transsexuals.

Describe the risk factors as per SOC for hormone therapy.

Describe the risk factors as per SOC for sex reassignment surgery.

Identify contra-indications for hormone or surgery recommendation.

List medical and other healthcare resources for the trans person.

3:00pm - 4:00pm Wrap up and final comments   
5/9 Day 7  

9:00am - 12:00pm



TGC 707 Legal & Ethical Issues

Describe the WPATH Code of Ethics.

Explain legal problems arising from differing laws in various jurisdictions.

Describe legal protections or lack thereof currently existing for trans people in the healthcare, correctional, employment, and military systems.

Explore the ethical dilemmas regarding minors transitioning.

12-1pm  Lunch  

1:00pm - 4:00

Lam & Volker

4pm - 5pm Wrap up and final comments  
5/10 Day 8  

9:00 am- 12:00 pm


Transgender Psychiatry/ Differential Diagnosis

 Differential Diagnosis

Exceptionswith case presentations

Body dysmorphia 

Gender queer, non or other gender 

Neuter and eunuch

Eunuchs case studies


self mutilation 

TG as a coping mechanism 

Physical Disabilities Issues

How people feel about this? Class discussion and process 

Guest presenter 

Psychiatric physician


Review psychiatric diagnoses and relate to transgender individuals.

Describe the interaction of psychotropic meds and hormone therapy 

Recognize those conditions out of the norm of transgender. 

Assess and treat individuals who are gender non-conforming and not typically transgender.

Implement treatment strategies for suicidal or self-mutilative individuals.

Identify those individuals who want to live in the other gender because of trauma or impaired thinking.

Identify personal biases and counter-transference regarding variations of gender non-conformance.

Assess for and therapeutically address co-occurring disorders.

Develop and implement a treatment plan for transition within the parameters of the co-occurring disorder.

12pm -1 pm Lunch  

1:00pm - 5:00pm

Lam, Clark,



Post-op care 


going stealth

Dealing with post-op clients when another therapist approved the surgery and it didn’t work out 

3. Regrets and Remorse

Make effective and relevant referrals.

Identify potential issues and develop a treatment plan for post-hormone and post-surgery life.

Describe post-op medical and emotional issues and utilize appropriate interventions

Implement treatment interventions with post-op transsexuals who are experiencing remorse or regret about transition.


Transgender Care Resources

Bockting, W. O. & Coleman, E., eds. (1992). Gender Dysphoria: Interdisciplinary approaches in clinical management. Binghamton, NY: Haworth Press. $34.56 on
Standards of Care (2013). The World Professional Association for Transgender Health free on

Answers to Your Questions About Transgender People, Gender Identity, and Gender Expression. American Psychological Association.

Beyond the Binary: A Tool Kit for Gender Identity Activism in Schools

Kirk, S & Rothblatt, M. (1995). Medical, legal and workplace issues for the transsexual: A guide for transformation. Watertown, MA: Together Lifeworks.
Schroth, L. E. ed. (2014). Trans Bodies, Trans Selves: A Resource for the Transgender Community. New York: Oxford University Press.
Stevenson, M. R. & Cogan, J. C. Eds. (2003). Everyday Activism. New York: Routledge Press.
Stuart, K. E. (1991). The uninvited dilemma: A question of gender. Portland, OR: Metamorphous Press.
Teich, N. M. (2012).Transgender 101: A Simple Guide to a Complex Issue. New York: Columbia University Press.
Zucker, K. J. & Bradley, S. J. (1995). Gender Identity Disorder and Psychosexual Problems in Children and Adolescents. New York, NY: Guildford Press.


The Middle Sexes, Parts 1-11, 

Trans, Chris Arnold, director, IICS website
Intersex, IICS website
Oprah on Transgender, IICS website

Resources (to date)

Advocates for Youth- Ten Tips for Parents of a Gay, Lesbian, Bisexual or Transgender Child & I Think I Might be Transgender, Now What Do I Do?

ANSWERS TO YOUR QUESTIONS About Transgender People, Gender Identity, and Gender Expression American Psychological Association.

BEYOND THE BINARY: A Tool Kit for Gender Identity Activism in Schools

CDC Centers for Disease Control & Prevention. Lesbian, Gay, Bisexual, and Transgender Health—Youth

COLAGE Kids of Trans Program (for children with transgender parents)

Deaf Queer Resource Center

EVERYDAY ACTIVISM. Michael R. Stevenson and Jeanine C. Cogan, Ed. New York:Routledge, 2003.

FACT SHEET: Transgender & Gender Nonconforming Youth in School. Sylvia Rivera Law Project

Gay/Straight/Trans Alliances: A Student Guide

Gender Education & Workplace Advocacy

Gender non-conforming: child, family, medical, mental health issues/resources

GLBTQ: The Survival Guide for Queer and Questioning Teens by Kelley Huegel—grades 9 and up

GLSEN (Gay, Lesbian and Straight Education Network) HARSH REALITIES: The Experiences of Transgender Youth in Our Nation’s Schools. & Miami-Dade County

Public Schools Gender Resource Guide (available from the YES INSTITUTE, Miami Florida)

International Foundation for Gender Education

Intersex Society of North America

If YOU ARE CONCERNED ABOUT YOUR CHILD’S GENDER BEHAVIORS: A Guide for Parents. Children’s National Medical Center

Lambda Legal Defense and Education Fund

LINKS for Transgender Youth

LOVE MAKES A FAMILY. By Gigi Kaeser & Peggy Gillespie—all grades

LUNA by Julie Ann Peters A story of a transgender brother/Grades 9 and up

MY GENDER WORKBOOK :How to Become a Real Man, a Real Woman, the Real You, or Something Else Entirely. By Kate Bornstein. New York: Routledge, 1998.

National Center for Transgender Equality

National Coalition for Gay, lesbian, Bisexual and Transgender Youth

National Gay and Lesbian Task force

National Youth Advocacy Coalition


PFLAG (Parents, Families, and Friends of Lesbians, Gays, and Transgender)


Safe Schools Coalition . Model School District Policy Regarding Transgender and Gender NonConforming Students—

THE FAMILY BOOK by Todd Parr. K-grade 3

THE TRANSGENDER CHILD by Stephanie Brill and Rachel Pepper. 2008.

The World Professional Association for Transgender Health

TransFaith Online. Spiritual and Religious Issues


Transgender Living on YouthResource

TRANSITIONS OF THE HEART—Stories of Love, Struggle and Acceptance by Mothers of Transgender and Gender Variant Children by Rachel Pepper. Cleis Publishers, 2012.

TRANSGENDER VISIBILITY: A Guide to Being You. Human Rights Campaign

Trans Youth Family Allies

Trevor Helpline Crisis Intervention for LGBT Youth 24 hours a day/7 days a week 1.800.850.8078

WORKING WITH TRANSGENDER YOUTH: Getting Down to Basics. A CWLA/LAMBDA Legal Joint Initiative &

Gender Role Interviews:

Bruce Jenner:

Gender Queer-ies: