Psychotherapists as Gatekeepers: An Evidence-Based Case Study Highlighting the Role and Process of Letter Writing for Transgender Clients
Psychotherapists as Gatekeepers: An Evidence-Based Case Study Highlighting the Role and Process of Letter Writing for Transgender Clients
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DOI：
10.1037/pst0000034
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发表时间：
2015-09-01
期刊：
影响因子：
2.5
通讯作者：
Budge, Stephanie L.
中科院分区：
文献类型：
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作者：
Budge, Stephanie L.
为了接受医学上必要的性别确认治疗，变性人必须提供他们准备好性别转换的证据。最常见的是，这个证据包括1个字母的激素治疗和2个字母的手术。根据世界跨性别健康专业协会（WPATH）的护理标准（SOC），心理治疗师或其他合格的卫生专业人员是唯一有资格写这些信的人。本案例研究探讨了如何心理治疗师守门和写信的变性客户交织在一起的心理治疗过程和结果。在12个月的治疗过程中，使用多种方法通过8个时间点对客户进行评估。其中6项评估采用了经验证的结局指标（基线;第5、10、15和20次会议;以及终止）;其中1项评估作为写信目的的临床访谈和其他结局指标（第8次会议）进行;评价写信过程是心理治疗的一个方面（第20次会议）。从基线至终止，症状缓解、心理健康改善和总体生活质量提高。结果表明，心理治疗有助于性别转变的过程，这反过来又改善了客户的结果。其中包括为希望性别转变的客户写信的建议。
In order to receive medically necessary gender-affirming treatments, transgender individuals are required to provide evidence of their readiness for gender transitioning. Most often, this evidence includes 1 letter for hormone therapy and 2 letters for surgery. According to the World Professional Association for Transgender Health (WPATH) Standards of Care (SOC), psychotherapists or other eligible health professionals are the only individuals qualified to write these letters. The present case study examined how psychotherapist gatekeeping and letter writing for a transgender client were intertwined with psychotherapy processes and outcomes. Over the course of 12 months of treatment, the client was assessed through 8 time points using multiple methods. Six of the assessments were conducted with validated outcome measures (baseline; Sessions 5, 10, 15, and 20; and termination); 1 of the assessments was conducted as a clinical interview for letter-writing purposes and additional outcome measures (Session 8); and evaluating the process of letter writing was an aspect of psychotherapy (Session 20). Symptom alleviation, improvement in psychological well-being, and increases in overall quality of life occurred from baseline to termination. Results indicate that psychotherapy assisted with the process of gender transitioning, which in turn improved client outcomes. Recommendations for writing letters for clients who desire a gender transition are included.