Glossary for NASW Ethics Table Talk
Gender-Affirming Care in Social Work: Exploring and Managing Ethical Responsibilities
Identity Terms:
Cisgender | Individuals whose current gender identity is the same as the sex they were assigned at birth.
Gender Expression | How an individual chooses to present their gender to others through physical appearance and behaviors, such as style of hair or dress, voice, or movement.
Gender Identity | An individual’s sense of their self as man, woman, transgender, or something else.
Non-binary | An adjective describing a person who does not identify exclusively as a man or a woman. Non-binary people may identify as being both a man and a woman, somewhere in between, or as falling completely outside these categories. While many also identify as transgender, not all non-binary people do. Non-binary can also be used as an umbrella term encompassing identities such as agender, bigender, genderqueer or gender-fluid.
Queer | A term people often use to express a spectrum of identities and orientations that are counter to the mainstream. Queer is often used as a catch-all to include many people, including those who do not identify as exclusively straight and/or folks who have non-binary or gender-expansive identities. This term was previously used as a slur but has been reclaimed by many parts of the LGBTQ+ movement.
Questioning | A term used to describe people who are in the process of exploring their sexual orientation or gender identity.
Sex | An individual’s biological status as male, female, or something else. Sex is assigned at birth and associated with physical attributes, such as anatomy and chromosomes.
Sex assigned at birth | The sex, male, female or intersex, that a doctor or midwife uses to describe a child at birth based on their external anatomy.
Sexual Orientation | Refers to a person’s sexual and emotional attraction to another person and the behavior and/or social affiliation that may result from this attraction (lesbian, gay, bisexual, etc.)
Sexual orientation | An inherent or immutable enduring emotional, romantic or sexual attraction to other people. Note: an individual’s sexual orientation is independent of their gender identity.
Transgender | An umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth. Being transgender does not imply any specific sexual orientation. Therefore, transgender people may identify as straight, gay, lesbian, bisexual, etc.
Medical and Psychosocial Terms
Gender Affirming Care | A range of social, psychological, behavioral, and medical interventions that help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity. (WHO Definition)
Puberty Blocker | The technical name for puberty blockers is gonadotropin releasing hormone analogues (GnRHa). These medications were initially developed to treat patients with extremely early pubertal development. When used continuously, these medications suppress the secretion of puberty hormones by the pituitary gland. (Pediatric Endocrine Society)
Gender Affirming Hormone Treatment (GAHT) | Gender-affirming hormones are a type of prescription medicine transgender and non-binary people can take to cause their body to begin physically developing into the gender they identify as. These medications allow transgender and non-binary people to live more fully as their identified gender, significantly reducing negative psychological outcomes such as gender dysphoria, depression, anxiety and suicidality. Gender-affirming hormone medications are synthetic versions of testosterone or estrogen, the same hormones that naturally develop at various levels in both cisgender men and cisgender women. (Definition from HRC)
Gender Affirming Surgery | Gender-affirming surgery includes a wide range of procedures such as plastic surgery to change features in the face to be more typically masculine or feminine, “top surgery” to make changes to the chest or torso or “bottom surgery” to make changes to genitals. (Definition from HRC)
Gender Dysphoria (F64.0) | Clinically significant distress caused when a person's assigned birth gender is not the same as the one with which they identify. DSM-5 Diagnosis
Gender Incongruence | A marked and persistent incongruence between a person's experienced gender and assigned sex (ICD - 11)
Sources:
Publications Related to Gender Affirming Care
American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832-864. https://www.apa.org/practice/guidelines/transgender.pdf
Austin, A. (2018). Transgender and gender diverse children: Considerations for affirmative social work practice. Child & Adolescent Social Work Journal, 35(1), 73-84.
Barsky, A. E. (2024, in press). Gender and sexual orientation matters. In P. Salem & K. Olson (Eds.), The family dispute resolution handbook. Oxford University Press.
Barsky[1], A. E. (2024, in press). Clinicians in court: A guide to subpoenas, depositions, testifying, and everything else you need to know (3rd ed.). Guilford Press. ISBN 9781462553327
Barsky, A. E. (2023, June 16). Ethics alive: Urgent alert – “Some states have banned gender-affirming care for transgender minors. What are our responsibilities?” The New Social Worker. https://www.socialworker.com/feature-articles/ethics-articles/urgent-alert-states-banned-gender-affirming-care-social-workers-responsibilities
Barsky, A. E. (2023). Essential ethics for social work practice. Oxford University Press. ISBN: 9780197585139 (paper and enhanced eBook with videos and interactive activities)
Barsky, A. E. (2020). Sexuality- and gender-inclusive genograms: Avoiding heteronormativity and cisnormativity. Journal of Social Work Education, 56(4), 1-11. https://doi.org/10.1080/10437797.2020.1852637
Barsky, A. E. (2019). Ethics and values in social work: An integrated approach for a comprehensive curriculum (2nd ed.). Oxford University Press. ISBN:9780190678111
Barsky, A. E. (2017). Conflict resolution for the helping professions: Negotiation, mediation, advocacy, facilitation, and restorative justice (3rd ed.). Oxford University Press. ISBN: 9780199361182
Belfort, E., & Brown, B. (2023). Individual affirming care: Psychological and social approaches to trans and gender-diverse youth. Child and Adolescent Psychiatric Clinics of North America, 32(4), 761-773. https://doi.org/10.1016/j.chc.2023.05.006
Bhatt, N., Cannella J., & Gentile, J.P. (2022). Gender-affirming care for transgender patients. Innovations in Clinical Neuroscience, 19(4-6), 23-32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341318/
Brown, C. (2023). Non-binary parents and carers: Naming the specific detriment faced. Proceedings of the 6th International Conference on Gender Research
Tordoff, D., Wanta, J., Collin A, Stepney, C, Inwards-Breland, D., & Ahrens, K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open, 5(2):e220978. http://10.1001/jamanetworkopen.2022.0978
University of Southern California, Dvorak School of Social Work. (2019). Four basic guidelines for practicing LGBTQ-affirming social work. https://dworakpeck.usc.edu/news/four-basic-guidelines-for-practicing-lgbtq-affirming-social-work