Article Published: 5/24/2023
Transgender youth face unique challenges in and outside of school. They also bear disproportionate mental health burdens. Transgender youth are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to their cisgender peers. School counselors are in an important position to provide support to and advocate for transgender students.
Clark D. Ausloos, PhD, NCC, LPCC, LPSC, is a passionate expert on transgender youth issues. His research on the topic has appeared in The Professional Counselor. He is a core faculty member in the school counseling program at the University of Denver. Dr. Ausloos is Chair of the NBCC Minority Fellowship Program Advisory Council and a member of NBCC’s Examination Sensitivity and Bias Review Committee. He is involved in numerous other counseling organization committees and editorial boards.
Dr. Ausloos began working with transgender individuals early in his career.
“I began working in schools with students with nondominant or marginalized gender identities. And then I started to clinically, where I saw college students who identified as trans or gender-expansive. Gender-expansive is a term that we’re often using to encompass a broad array of diverse gender identities, including transgender, gender-diverse, nonbinary, genderfluid, agender, bigender, etc. Outside of that work at the university, I worked at a private practice where I saw mainly trans youth and their families. My experiences have been with those throughout the life span as well as clinical locations in addition to educational settings.”
As a researcher, Dr. Ausloos has conducted several studies examining how counselor education training programs can better inform students to work with transgender clients. A current research project involves the experience of gender-expansive graduate students and the impact on their development as counselors.
“In addition to the clinical training piece, I’m interested in what ways professionally licensed counselors in clinical and in school settings are best working with trans students. What are they finding as sources of resilience and pieces of success in working with trans students in schools and communities? My research looks at both the training and the clinical or school practice of counselors.”
Challenges and Barriers
According to Dr. Ausloos, transgender students face unique challenges in school.
“Some of the biggest barriers are related to equity in schools, related to a student’s authentic identity and that identity being validated in a school setting. Whether that means a student is being referred to by their authentic name. Whether that’s folks in the school system misgendering students or not adhering to those students’ pronouns.”
Many schools have policies that are problematic or poorly implemented for transgender students, according to Dr. Ausloos.
“We see discriminatory practices related to dress code for trans students and policies related to gym class and health class. This branches off into physical, mental, and social safety in settings related to trans students using the bathroom or the locker room that is associated with their gender identity and not what we refer to as sex assigned at birth. Additionally, we see challenges with school systems that are engaging in field trips or overnight stays with trans students being placed with the sex they were assigned at birth, in those groups, and not with students of the same gender identity.”
Additional challenges relate to disclosure and privacy.
“Who needs to know that the student is trans, and are their parents aware? If this person is rooming with another student, what does that look like as far as confidentiality?”
Dr. Ausloos sees many ways schools are falling short in supporting transgender students.
“There’s a lack of clear antidiscrimination policy related to gender and sexuality that we see in school district policy, but that can really essentially protect our trans students.”
Many schools lack other supports for transgender students, including Gender and/or Sexuality Alliance (GSA) clubs.
“We don’t see those in every school. We see hesitation and challenges from parents and community members when students and faculty try to implement such affirming groups in schools.”
Advocating for Students
There are ways schools can better prepare to support transgender students, and counselors can advocate for these. Schools can benefit students by removing binary language from ways of classroom management and classroom structure. This can be particularly helpful for students who are nonbinary or genderfluid.
“These individuals often get lost in the shuffle because our society needs to put people into concrete, binary categories.”
“I think the biggest part of school counselor impact can be working with other stakeholders in the building to advocate for trans students,” says Dr. Ausloos. “Including providing psychoeducation to those stakeholders. So namely educators, administrators, all school staff. I think that the important piece is advocating for students who are of diverse identities and providing information to those groups.”
School counselors are in an important position to educate faculty, staff, and others about transgender issues.
“An important part of our role is to support and provide data to stakeholders in schools that demonstrates the importance of affirmative, inclusive, and representative spaces for trans students and what that looks like compared to not having those spaces. And being direct in sharing striking and concerning statistics regarding trans students and their mental health concerns and the risk factors if not supported in schools.”
Teachers and staff can benefit from professional development training and more personal work on what gender identity means to them.
“They should work on awareness of their own biases and discrimination that they could potentially be conducting or engaging in without knowing it.”
Language is important and can make a difference in subtle ways. Dr. Ausloos advocates for avoiding the term “preferred pronouns,” in favor of simply “pronouns.”
“‘Preferred pronouns’ can be stigmatizing and almost devaluing someone’s identity in the sense of ‘I prefer this, but I also could go by this.’” Referring to a student’s pronouns or name, without qualifying those as “preferred,” reinforces that this is their identity.
A common mistake for faculty and staff is to misgender a student, so it is important to educate them on how to deal with this situation. Don’t make a big deal out of the interaction and draw a lot of attention to the situation, as that might make the student self-conscious and further marginalized. It can also burden the transgender person with the feeling that they need to provide reassurance that they weren’t offended and provide proper education to cisgender people.
“We all make mistakes, we’re all human. And a problem I’ve found with folks is ‘I’m so scared to make a mistake, I don’t say anything.’ So that this trans student feels invalidated, not supported. I think the biggest thing, and research supports this, is that, if we do make a mistake with a trans student regarding names or pronouns, our best practice is to apologize. It’s to really reflect on how I’ll use this information moving forward, and then to move forward.”
According to Dr. Ausloos, counselors are not always well prepared to work with transgender clients.
“I would say that it’s unfortunate but a true fact that both school and clinical counselors lack the training and specificity of the nuances of working with trans students and clients.”
The first step in supporting transgender students, says Dr. Ausloos, is for counselors “to be aware of their own biases, beliefs, self-histories, self-identities” when it comes to gender in general, and regarding their experiences with transgender or gender-expansive individuals.
“You know, if I have a certain feeling or belief or bias or thought—which we all do, we all have implicit biases—we need to ask ourselves, where did I learn this from? From whom did I learn it? How did I come to feel this way or know this? These are important things to dig into for a counselor, for their own self-awareness and self-efficacy in working with trans clients. That’s the first step and that relates back to our multicultural and social justice counseling competencies.”
Part of this process is avoiding assumptions about a transgender student’s identity based on preconceptions.
“Trans and gender-expansive students experience their gender and identity and expression in very different ways. Each person’s journey is unique, and this trans student may want to transition or affirm their gender in a certain way that others do not. And we need to check ourselves on our own feelings and expectations and biases. Each student is different and individual in their journey.”
Counselors must also understand the difference between sexual identity, sexual orientation, gender identity, and gender expression.
“Not only is this important for school counselors to know as a basic tenet, but they should be able to provide psychoeducation and consultation to parents and others in the building. Keeping in mind confidentiality, they can provide that information as a source of knowledge for others as a way of reducing stigma and advocating for students.”
Counselors should enhance their knowledge of how a student might socially affirm their gender. This can include students presenting themselves in a different way via hairstyle, makeup, and dress. Counselors should also be familiar with the types of medical gender-affirming procedures and the impact these might have on a student’s mental health and social identity—while recognizing that medical advice is beyond a counselor’s scope of practice.
In Dr. Ausloos’s view, the three counseling principles that are best practice in working with transgender students are affirmative counseling, celebratory counseling, and liberatory counseling.
“These are new concepts that are often used in other settings that school counselors can start to adapt into their practice. With an affirmative counseling lens, school counselors are validating a student’s identity, their name, their pronouns.”
Dr. Ausloos highlights the importance of school counselors’ ability and knowledge of working with family systems and other stakeholders. This includes knowing what is beyond a school counselor’s competence as indicated by professional standards and knowing how and when to refer families to services outside the school system.
“That does not mean that we, as counselors, cannot be one of the most affirming and safe and validating sources for students in their lives,” says Dr. Ausloos.
Providing services to a transgender student also means knowing what is happening at home. Parents may sometimes struggle to understand their child’s experience.
“I emphasize balancing the student’s desires and goals with a parent’s expression and emotions about their child and their gender identity. And so, it’s kind of balancing student goals with parent expectation and helping students navigate the expectation of ‘your parents have known you this way for many years and now we’re seeing you as the person who you are.’ This could be challenging to your parents. What are some ways that we can work through this?”
It’s important that students have a safe and validating environment at home. With a student’s approval, a counselor can provide psychoeducation and advocate on behalf of or with the client to their parents.
“I would bring to attention the piece of confidentiality and the importance of being sensitive and attuned to the student’s response and feelings about their safety and the acceptance and validation of those in their lives at home and in the community, so that school counselors are sending students back home to a safe environment and are making sure that trans students receive the care that they need.”
As with all students, counselors should be alert for signs of trouble at home. Parents who reject a child’s identity may not provide a safe home environment. In some cases, it may be necessary to contact a child protective service agency, says Dr. Ausloos.
“Now, I say that with the context that school counselors are not investigators and school counselors are not making final decisions, but it is our duty and obligation to report folks that potentially could be causing immediate harm. And harm is defined in many different ways in many different states. So that’s another piece to look at within your state.”
The Current Climate
This is a particularly difficult time for transgender students, with anti-trans legislation passed or considered in numerous state legislatures. Surveys and anecdotal evidence show that this climate can be harmful to transgender students’ mental health.
“We know this from folks who work with students who share their concern and fears about their future and their well-being on this legislation,” says Dr. Ausloos. “I’m thinking about students that I work with in a clinical setting even that have shared just extreme fears of ‘What will happen to me. Will I have to detransition?’”
Additionally, where such laws have passed, they may have direct implications for school counselors’ work.
“We have a variety of different states that are really invalidating and minimizing a trans student’s identity and additionally making it challenging for students to come out or even express their gender identity to a counselor, because the counselor in certain states might be required to report that information, essentially outing a student, which in turn is harmful to that student and their mental health and well-being."
All this can put school counselors in a very difficult spot.
“The important things are that the school counselor is aware and knowledgeable of what’s going on in a legal and ethical sense. So, we have to balance as school counselors our ethical duties and mandates that are put forth to us, as well as navigating the political and legal landscape, which oftentimes I think for school counselors can be challenging. And I encourage school counselors, when possible, to use an ethical decision-making model to work through some of these issues that may not be cut and dry, black and white.”
Dr. Ausloos recommends that school counselors keep up with legislative action in their state to know what is in consideration or has passed and how it might affect transgender students as well as counselors’ practice. School counselor licensure laws and regulations are determined by each state, so it is important to stay aware of developments.
Dr. Ausloos also urges counselors to get involved and advocate.
“It’s now more important than ever that we as school counselors, professional counselors, step up and really engage in our ethical duty of advocating for and with our students.”
He suggests contacting local counseling or LGBTQ+ organizations. They may provide templates, scripts, and other tools for advocating with legislators. This can make it much easier to get involved and make one’s voice heard.
School counselors serve an important role in this dangerous climate.
“School counselors can serve as the biggest advocates for students. Having just one supportive adult in the school system for a student greatly reduces the chance of suicidal ideation and suicidal completion. So, school counselors can help to establish supportive relationships, whether that’s them or another person that is a support to that student, reducing their mental health symptomology and suicidality.”
Counselors should be aware of local resources to which they can direct transgender students in need of support.
“School counselors need to know community resources in their area that are affirming, inclusive, respectful, and celebratory of trans youth and trans students. And I think that comes twofold. One is vetting those places yourself by asking questions that you know will elicit what type of affirming service that is. I also think the second piece is learning from your students and clients who are trans or gender-expansive, who have, themselves, trusted sources in outside community providers.”
Dr. Ausloos recommends several national resources that counselors can provide to students. The Trevor Project provides information and direct assistance to LGBTQ youth. Stand With Trans is another nonprofit that provides support for transgender youth and their families. The National Center for Transgender Equality advocates for and provides resources to transgender individuals.
Resources and Professional Development
Dr. Ausloos recommends that school counselors reference and study the standards and best practice guidelines put forth by professional organizations such as the American School Counselor Association and the American Counseling Association. These organizations have divisions focused on diversity and equity, which can be valuable sources of guidance and information.
The Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE) is a division of ACA that provides best practice guidelines for working with transgender and gender-expansive students and others. ASCA has best practices and many other resources related to working with LGBTQ students. Another important organization is the World Professional Association for Transgender Health (WPATH), which provides standards for working with transgender students. GLSEN is an organization that works to support LGBTQ students across the country. GLSEN’s “Supporting Safe and Healthy Schools” report provides valuable information for school counselors. The Trans Youth Equality Foundation provides education, advocacy, and support for transgender children, youth, and their families. The National Center on Safe Supportive Learning Environments also offers useful resources for school counselors and educators.
Dr. Clark D. Ausloos is a National Certified Counselor, a Licensed Professional Clinical Counselor, and a Licensed School Counselor. Dr. Ausloos has worked in elementary, intermediate, and junior high school settings, as well as private practice, and in higher education. Dr. Ausloos has worked with students at the College of William and Mary, as well as Palo Alto University and is now serving as Clinical Assistant Professor in the SchoolCounseling@Denver program at the University of Denver. Dr. Ausloos centers his clinical, school, and scholarly work on supporting and advocating for marginalized, nondominant populations, specifically queer and trans youth, and their families. Dr. Ausloos has authored over 17 peer-reviewed manuscripts and has several book chapters and encyclopedia terms in press, in addition to presenting over 40 conference presentations. Dr. Ausloos serves on numerous professional counseling organizations and counseling divisions, including ACA, AARC, SAIGE, ACAC, and ACSSW.
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