Podcast Summary: Creating a Transgender Inclusive and Affirming Private Practice
Podcast: Private Practice Startup
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Dr. Andre Caruso
Episode: 139
Date: June 8, 2019
Episode Overview
This episode focuses on how mental health professionals can foster a transgender-inclusive and affirming private practice. Host Katie Lemieux (flying solo without Kate Campbell this week) interviews Dr. Andre Caruso, a clinical psychologist with expertise in LGBTQ+ mental health. The conversation covers essential terminology, practical tips for inclusive paperwork and office spaces, understanding pronouns, and the importance of ongoing education.
Key Discussion Points & Insights
1. Why Focus on Transgender Inclusivity?
- Dr. Caruso highlights the need for affirming spaces: “It is still one of the last known populations that we can still be prejudiced, discriminated against openly.” (04:29)
- Transgender identities are not new or a “trend” — they’ve existed throughout history but are only now entering public consciousness in modern ways. (05:05)
2. Core Terminology & Definitions
Dr. Caruso provides foundational definitions for clinicians:
- Sex: “The part you were born with in between your legs when you came out at birth.” (06:53)
- Gender: “How you feel. You can be born with male sex at birth, but you can identify as a female.” (07:06)
- Gender Identity: “How you identify...any point on a spectrum.” (07:16)
- Gender Expression: “How you express yourself... doesn’t have to match what we traditionally think.” (07:49)
- Sexual Orientation: “Separate from your gender.” (08:11)
- Cisgender: “If you match your gender with your sex at birth, that’s considered cisgender.” (04:36)
- Transgender (adj): “An umbrella term, but also very specific to how you feel. It is an adjective, not a noun.” (09:03)
- Important: Do not say “a transgender” or “transgendered.”
- Non-Conforming / Nonbinary / Gender Fluid / Genderqueer: Different expressions that do not fit neatly into binary gender boxes.
- “There is no steadfast rule...It’s unique to the person.” (11:35)
3. Handling Mistakes and Showing Respect
- It’s common to worry about offending or making mistakes. The best course is always to ask respectfully, rather than assume.
- Katie: “My biggest fear is offending people. I want to always make sure I’m speaking to them in the way that they want and showing compassion.” (12:07)
- Dr. Caruso: “The best practice is to ask...We should do this almost naturally with everyone.” (12:59)
- If you misuse a pronoun or make a mistake: apologize, correct yourself, and move on. Don’t dwell or over-explain.
- “If you do make a mistake with a pronoun...apologize and move on.” (20:12)
4. Inclusive Paperwork and Administrative Practices
- Dr. Caruso recommends specific approaches:
- For names: avoid “preferred” name; simply use “name.”
- Provide blanks for “Name,” “Legal Name (if different),” “Gender Identity,” and “Pronouns.”
- For EMRs: if you must use dropdowns, “make sure there’s at least a spot for ‘other’ at the very least” and lobby for more inclusive options. (13:50)
5. Understanding & Using Pronouns
- Pronouns: she/her/hers, he/him/his, they/them/theirs, and less commonly, ze/zir/zirs. (16:26)
- “If you’re ever unsure, always go to the singular ‘they.’ It fits everyone.” (17:05)
- Increasing presence of “Mx” as a gender-neutral prefix (e.g., Mr., Ms., Mx.) in forms and licensing. (17:25)
6. Office Environment & Facilities
- Bathrooms: Make spaces as gender-neutral as possible; lobby for inclusive signage or policies if possible.
- “If you’re renting space in a bigger office building...as long as people use the bathroom that fits their gender identity, they are more aware than we are.” (19:05)
- Discuss clients’ preferences and reservations in session for their comfort and safety. (19:40)
7. Being an Ally and Ongoing Education
- Be a conscious, active ally by not assuming, asking respectfully, and consistently educating yourself.
- “Just understand it and respect that everyone is different...If you make the effort, that’s really appreciated.” (20:24)
- Language evolution: “Everything...is constantly changing, so just do your best to keep educating yourself.” (23:49)
8. Difference Between Gender and Sexuality
- “Your gender identity and your sexual orientation are two totally different things.” (25:02)
- Explains how a transgender person's sexual orientation is defined just like anyone else's, depending on attraction rather than gender identity. (25:13)
Notable Quotes & Memorable Moments
-
Dr. Caruso, on history and terminology:
“We think of it [transgender identity] as a new thing, but it’s been around since the beginning of time.” (05:05) -
On paperwork:
“We don’t say ‘preferred’ anymore...it puts that wrong connotation...It’s not preferred, it’s just their name.” (13:30) -
On pronouns:
“The ‘they’ is the easiest one...We use it all the time.” (17:05) -
On making mistakes:
“If you do make a mistake...apologize and move on. Everyone usually is open to mistakes and people learning.” (20:12) -
On inclusivity:
“Everyone is equal and everyone is a person. If we break down those stereotypes...and just work together to change our language a little bit...we can help everyone become equal.” (27:21)
Practical Takeaways & Inclusive Actions
- Ask respectfully about name and pronouns; never assume. (12:59)
- Revise paperwork: Remove “preferred,” provide blanks for open answers, and distinguish “Legal Name (if different)” for records. (13:30)
- Use inclusive pronouns and language: Adopt singular “they” when unsure, and explore “Mx” as a gender-neutral prefix. (17:05, 17:25)
- Advocate for gender-neutral spaces where possible; discuss comfort with facilities directly with clients. (19:05)
- Emphasize curiosity, humility, and willingness to learn as an ally: If you don’t know, ask and keep up with evolving terminology. (20:24, 23:49)
- Understand the distinction between gender identity and sexual orientation; educate clients and yourself on this point. (25:02)
Recommended Resources
- Local: SunServe.org (Fort Lauderdale), YES Institute (Miami)
- “They have a lot of links on their website also...always a place you can go...” (22:56)
- Global: WPATH, the World Professional Association for Transgender Health
- “It’s the biggest organization...it is the one that’s leading the world.” (23:10)
- Other: Seek ongoing training, consultation, supervision. Refer out when not within your scope. (24:15)
Memorable Moments & Giveaways
- Unicorn as a symbol:
Dr. Caruso’s practice logo is a unicorn, “because all people are unique...it also signifies hope and caring for everyone.” (26:05) - Free consulting offer:
“If you want...a little bit more info, or if you just want to talk a little bit more of the topic, I’d love to talk. Please just give me a shout.” (26:48)
Timestamps for Key Segments
- Introduction & personal context: 00:27–04:14
- Core definitions & history: 04:14–08:45
- Clarifying terminology (transgender, nonbinary, etc.): 08:54–12:53
- Practical inclusivity (paperwork, pronouns): 12:53–17:25
- Office environment, bathrooms, allyship: 18:19–22:17
- Resources for therapists: 22:56–24:15
- Difference between gender and sexuality: 25:02–25:59
- Unicorn practice logo explanation: 26:05–26:38
- Dr. Caruso’s consulting offer: 26:48–27:13
- Final takeaways & sign-off: 27:20–30:22
Closing Thought
The journey to building a transgender-inclusive and affirming practice is ongoing and, above all, built on respect and willingness to learn. As Dr. Caruso put it:
“If we break down those stereotypes and thoughts that we have and just work together to change our language a little bit...we can help everyone become equal.” (27:21)
