Working with Transgender and Diverse Clients


Presenter: Arlene Lev, LCSW-R, CASAC

This course is part of the LGBTQIA Affirmative Therapy Certification offered my MSTI.




  1. Differentiate between sex, gender identity, gender expression, gender role, and sexual orientation.
  2. Discuss the diversity of transgender and gender nonbinary individuals.
  3. Examine personal bias and perceptions of sex and gender to provide affirming care.
  4. Describe gender affirming care for adults.
  5. Discuss sexual orientation and gender identity
  6. Discuss discrimination, bias, and minority stress.
  7. Describe WPATH SOC 7 and DSM-5.
  8. Define cultural competency and humility.

Activity Outline:

1)             Introduction & Overview (10 minutes)

  • Arlene Lev, LCSW, CASAC, CST
  • Acey Mercer, LMSW
  • Learning Objectives

2)             Definitions (30 minutes)

  • Sex, Gender, Gender Identity, Gender Expression, Gender Roles
  • Challenging assumptions of masculinity and femininity
  • Transgender, Transsexual, Cisgender, Cissexism, Gender Diverse, Nonbinary, Sexual orientation

3)             Affirmative Clinical Treatment (65 minutes)

  • What clients are looking for and often find
  • Gatekeeping
  • Clients seeking services
  • Evaluating gender dysphoria
  • Issues facing families

4)             Sexual Orientation and Gender Identity (45 minutes)

  • Transgender Emergence model
  • Overlap of sexual orientation and gender identity
  • Shifting identities
  • Relational and intimacy concerns

5)             Discrimination & Bias (45 minutes)

  • National Transgender Discrimination Survey
  • Barriers to care
  • Cultivating an affirming atmosphere
  • Goals for treatment
  • Role of the provider
  • Collecting client history
  • Family & Advocacy
  • Gender Assessment Tools