Gender-Affirming Care Certificate Session Outlines

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Gender Affirming Care Certificate Program

Weekly Session Outlines

Week 1: Foundations of Gender-Affirming Care

Summary:

  • Introductions, group agreements, and expectations
  • Core principles of gender-affirming care

Agenda:

  • Group introductions and expectations
  • Homework/show & tell activity: objects representing gender
  • Reflection: “What is your gender, and how do you know?”
  • Establishing group agreements (curiosity, vulnerability, receptivity to feedback)
  • Principles: client-centered, intersectional, inclusive, curiosity-positive, sex-positive, culturally humble, liberation-oriented

Educational Goal:
Establish a supportive, inclusive space by rooting participants in shared language, ethical principles, and self-awareness—centering intersectionality, curiosity, and liberation as the foundation for all gender-affirming clinical care.

Learning Objectives:

  • Define and illustrate the seven core principles of gender-affirming care.
  • Reflect on personal identity and bias, and describe its impact on clinical work.
  • Distinguish the components of person-centered, intersectional, and liberation-oriented practice.

Week 2: Deconstructing

Summary:

  • Deconstruct sex and gender binaries
  • Analytic models of gender
  • Reflective and experiential activities (gender mapping)

Agenda:

  • Break down distinctions: sex assigned at birth, gender identity, gender expression
  • Group/individual exploration of “doing” vs. “being” gender
  • Small group: gender mapping/collage/art exercise
  • Societal expectations and gender norms discussion

Educational Goal:
Guide participants to break down binary gender concepts, applying rich, multidimensional models and fostering critical reflection on both their own and clients’ lived gendered experience.

Learning Objectives:

  • Differentiate between sex assigned at birth, gender identity, and gender expression.
  • Analyze how cultural norms and expectations shape gender performance and self-understanding.
  • Facilitate inclusive, client-centered exploration of gender beyond binaries.

Week 3: Scientific Understandings of Sex and Gender

Summary:

  • The (bio)social evidence against the sex/gender binary
  • Clinical mythbusting.

Agenda:

  • Homework review and breakout discussion
  • “Myth or fact?” session: debunking biologically-determined gender/sex claims
  • Case review: intersex realities, spectrum of sex/gender traits
  • Clinical implications: assessment, documentation, psychoeducation

Educational Goal:
Empower clinicians with up-to-date evidence dismantling gender/sex essentialism, fostering science-based, non-binary–inclusive client advocacy.

Learning Objectives:

  • Identify scientific myths vs. facts about sex/gender differences.
  • Evaluate documentation and policy through a non-binary lens.
  • Educate clients and stakeholders using evidence-based approaches.

Week 4: Intersex Health and Human Rights

Summary:

  • Realities, rights, and advocacy for intersex clients.

Agenda:

  • Documentary homework (Every Body) and in-session journaling
  • Medical definitions, common variations, and lived experience
  • Advocacy frameworks (informed consent, legal protections)
  • Resource/discussion: support tools and human rights statements

Educational Goal:
Equip clinicians to advocate for and provide ethical, affirming care to intersex clients by challenging pathologizing medical models and uplifting autonomy and justice.

Learning Objectives:

  • Recognize common intersex traits and debunk stereotypes.
  • Summarize ethical statements and legal frameworks supporting consent.
  • Apply advocacy and resource referral strategies for intersex clients.

Week 5: Gender-Expansiveness Through the Ages

Summary:

  • Global cultures, pre-colonial gender expansiveness, colonial harms.

Agenda:

  • “Sacred place” meditative journaling
  • Group research: Gender expansiveness throughout the ages
  • Class presentation: lessons from gender-expansive leaders
  • Discussion: integrating anti-colonial perspectives, applying history to practice

Educational Goal:
Situate gender-affirming care in its global, anti-colonial, and historic context, encouraging integrative, justice-based frameworks.

Learning Objectives:

  • Summarize the impact of colonialism on global gender expansiveness.
  • Integrate lessons from diverse gender/nonbinary historical figures.
  • Apply anti-colonial perspectives to modern clinical assessment and support.

Week 6: Transphobia, Oppression, and Clinical Advocacy

Summary:

  • Dynamics of transphobia, anti-trans movements, harm reduction, and resilience.

Agenda:

  • Discussion: Disclosure (Netflix), sports/health care bans, maps, legislation
  • Case study: intersectional violence and oppression (including transmisogyny)
  • Group activity: body mapping, art, and journaling resilience and resistance
  • Applied strategies: anti-oppression and system change in clinical care

Educational Goal:
Foster deep understanding of transphobia’s systemic roots and impacts, while providing clinicians practical tools for client resilience-building and advocacy.

Learning Objectives:

  • Identify the mechanisms and impacts of transphobia, transmisogyny, and institutional oppression.
  • Demonstrate practical tools for resilience-building in clinical practice.
  • Develop advocacy strategies for supporting TGD clients facing systemic harm.

Week 7: Analyzing the Rise of Anti-Trans Discrimination

Summary:

  • Rise of anti-trans discrimination, organized attacks, legal/policy threats.
  • Anti-trans movements, misinformation, and impact on care.

Agenda:

  • Discussion: homework readings on anti-trans extremism, far-right narratives, and wedge issues.
  • Analysis of sports, health care, bathroom, and school bans in addition to other political targeting of the trans community.
  • Mapping and explaining the three wings of the anti-trans movement (TERF, Far-Right, Disinformation).
  • Activity: Group research/presentations.
  • Resilience and clinical advocacy strategies.

Educational Goal:
Equip clinicians to critically analyze and effectively respond to current anti-trans legal, political, and cultural attacks impacting client care, with a focus on resilience and advocacy.

Learning Objectives:

  • Identify key tactics and actors driving anti-trans discrimination and legislation.
  • Analyze the real-world impacts of these attacks on clients’ mental health and access.
  • Develop advocacy and resilience-building strategies for clinical and community settings.

Week 8: Transition Outcomes and Clinical Support

Summary:

  • Research and myths regarding outcomes of transition, “detransition,” and regret.
  • Nuanced understanding of gender fluidity and clinical response.

Agenda:

  • Review of evidence: mental health impacts of medical/social transition.
  • Homework discussion.
  • Discussion: Desistence, detransition, and research critiques.
  • Client support for exploring and/or reversing transition.
  • Activity: Breakouts analyzing flawed/desistance/detransition studies.

Educational Goal:
Give clinicians research-informed, compassionate tools to guide, affirm, and support clients in all phases of transition, including those questioning or ceasing medical or social transition.

Learning Objectives:

  • Evaluate and apply current research findings regarding transition and detransition outcomes.
  • Provide affirming, nonjudgmental care to clients questioning or ceasing transition.
  • Support the normalization of exploration and fluid gender identity trajectories.

Week 9: S0-Called “Conversion Therapy” and Clinical Ethics

Summary:

  • History and practices of so-called “conversion therapy,” including gender-exploratory “new” approaches.
  • Clinical, legal, and ethical considerations.

Agenda:

  • History of so-called “conversion therapy,” aversive/behavioral practices.
  • Video and homework: Gender Exploratory Therapy Association critique.
  • Analysis of comorbidity, mental health, and conversion efforts.
  • Legal status, clinician responsibilities, and strategies for repair in clinical work.

Educational Goal:
Prepare clinicians to identify, reject, and ethically counteract all forms of conversion efforts—including those disguised as “exploratory therapy”—while affirming the right to self-determination.

Learning Objectives:

  • Define and recognize SOGICE, GICE, and their current clinical manifestations.
  • Explain ethical/legal bans on so-called “conversion therapy” and its impacts.
  • Employ clinical strategies to support identity exploration—but not coercion—in care.

Week 10: Supporting Gender Identity Development in Young People

Summary:

  • Gender identity development in youth
  • The importance of affirming support from families, schools, and communities.
  • Research review and debunking of common myths.

Agenda:

  • Film: Transhood discussion and personal reflection on gender roles/expectations.
  • Research review: youth gender identity development, persistence/desistance, critique of “rapid onset gender dysphoria” (ROGD), Cass Review.
  • Intersectionality: special focus on BIPOC and neurodivergent youth.
  • Clinical and school strategies: affirming environments, family dynamics, interventions.
  • Overview: social vs. medical transition, informed consent, current debates.

Educational Goal:
Equip clinicians to deliver developmentally sensitive, evidence-based, identity-affirming care to gender-diverse youth—centering self-determination.

Learning Objectives:

  • Describe gender identity development and diversity in children and adolescents.
  • Summarize research on the persistence/desistance of trans identity and mental health outcomes from transition.
  • Employ affirming, youth-centered clinical strategies, including engagement with non-affirming families.

Week 11: Resistance, Resilience, and the Power of Gender Euphoria

Summary:

  • The ways trans and nonbinary people practice resistance.
  • Differences between resistance and resilience.
  • The importance of gender euphoria.
  • Strategies for fostering resistance and euphoria.

Agenda:

  • Film: Orlando: My Political Biography – history, personal narratives, and collective resistance.
  • Discussion of readings and interviews to explore resistance, euphoria, and community building.
  • Guided activities: euphoria meditation, journaling, and “mad maps” exercises for exploring resilience against oppression.
  • Analysis of resilience vs. resistance: individual, relational, and community-level strategies.
  • Review of protective factors and research on the mental health impact of euphoria and social acceptance.

Educational Goal:
Equip clinicians to recognize and cultivate gender euphoria, and to support both personal and community resistance to transphobia—centering joy, affirmation, and empowerment in trans and nonbinary care.

Learning Objectives:

  • Define and distinguish resilience and resistance in the context of trans and nonbinary experiences.
  • Integrate strategies for fostering gender euphoria and protective social supports in clinical practice.
  • Apply tools (e.g., mad mapping, affirmation practices) to empower clients in developing both internal and collective resistance to oppression.

Week 12: Family and Community Support

Summary:

  • The importance of family and community acceptance.
  • The process of parental and family adjustment.
  • The importance of education and support to foster positive relationships and child wellbeing.
  • Community, faith networks, and supportive environment.

Agenda:

  • Film: Transformer—discussion of family and community reactions to transition.
  • Exploration of stages of family adjustment, strategies for building affirming familial relationships, and working with non-affirming parents.
  • Approaches for supporting partners and spouses during transition.
  • Analysis of community support structures (faith, peers, organizations) and their impact.
  • Review of provider roles: coaching, psychoeducation, community referrals, inclusion of cultural and faith considerations.
  • Activities on mapping support networks (Pod Mapping) and building inclusive environments.

Educational Goal:
Equip clinicians with strategies to facilitate family and community affirmation for TGD individuals—centering relationship-building, culturally responsive support, and resilience in care.

Learning Objectives:

  • Explain the impact of family acceptance and rejection on TGD mental health and wellbeing.
  • Employ clinical strategies to support families (affirming and non-affirming), partners, and build strong social networks for TGD clients.
  • Integrate community, cultural, and faith-based resources to cultivate inclusive environments for trans individuals.

Week 13: Sex, Love, and Relationships

Summary:

  • Sexual orientation and relationships among trans and gender-diverse (TGD) people.
  • Principles of affirming care as they pertain to sex, love, and relationships.
  • Experiences of intimacy, dating, and disclosure.

Agenda:

  • Guided collage activity: reflection on sexual history, orientation, and gender identity.
  • Discussion: norms and personal experiences in sexual orientation, identity, and relationships.
  • Video: Trans Talks: Love, Sex, and Intimacy—exploring dating, relationships, and violence for trans people.
  • Review: research on sexuality, orientation, and fluidity during/after transition.
  • Topics: mainstream and nontraditional relationship structures (monogamy, CNM, polyamory), dating and disclosure, consent, stigma, and cultural diversity.
  • Clinical focus: navigating disclosure in relationships and supporting intimacy, sexual function, and affirmation in partnership.

Educational Goal:
Prepare clinicians to provide sex-positive, identity-affirming, and culturally responsive care to TGD clients—focusing on healthy sexuality, affirming relationships, disclosure, and resilience across diverse experiences.

Learning Objectives:

  • Describe the diversity of sexual orientation, labels, and relationship structures among TGD people.
  • Summarize the impact of gender affirmation (social, medical) on sexuality, intimacy, and relationships.
  • Employ clinical strategies for supporting sexual health, disclosure, safety, and affirmation in sex and relationships for TGD clients.

Week 14: Medical Interventions and Healthcare Access

Summary:

  • Options for medical interventions.
  • Affirmation based on self-determination. 
  • Outcomes of gender-affirming medical care.
  • Factors impacting access to interventions.

Agenda:

  • Overview: puberty blockers (GnRH agonists), hormone therapies, and common surgical procedures (top, bottom, and other gender-affirming surgeries).
  • Current protocols: assessment standards, multidisciplinary care, informed consent, and parental/caregiver roles for youth.
  • Discussion: physical and psychological benefits/risks, fertility preservation, and ongoing monitoring.
  • Address: barriers to care (insurance, legislation, discrimination) and recent policy developments.
  • Review: research on mental health outcomes, regret, detransition, and the politicization of medical interventions.
  • Clinical practice: providing referrals, supporting decision-making, and navigating family/system support.

Educational Goal:
Enable clinicians to deliver evidence-based, individualized, and affirming medical care for TGD clients across the lifespan—grounded in current science, ethical practice, and patient autonomy.

Learning Objectives:

  • Describe key medical interventions (puberty blockers, hormones, surgeries) and the clinical indications for each.
  • Summarize evidence on mental health outcomes, regret, and detransition in gender-affirming medical care.
  • Apply ethical, client-centered frameworks to support access, informed consent, and continuity of care for TGD individuals seeking medical interventions.

Week 15: Assessment and Letter Writing: Ethics, Advocacy, and Practice

Summary:

  • Conducting assessments for gender-affirming medical procedures.
  • The difference between adult and minor assessments.
  • Letter writing principles.
  • Letter writing advocacy with providers and insurance companies.

Agenda:

  • Overview of WPATH & current standards of care for assessment and documentation.
  • Review of assessment practices: psychosocial, risk, resilience, needs, and readiness—inclusive of nonbinary, youth, and disabled clients.
  • Sample letter analysis: identifying pathologizing vs. affirming language.
  • Practice activity: drafting affirming letters for hormones, surgeries, or legal documentation.
  • Navigating insurance, legal systems, and institutional barriers.
  • Ethical, legal, and practical considerations for assessment across roles (therapist, medical provider, advocate).

Educational Goal:
Equip clinicians to conduct affirming, ethical assessments and write effective letters that facilitate timely, equitable access to gender-affirming care—centering autonomy, dignity, and individualized support.

Learning Objectives:

  • Describe assessment best practices for gender-affirming medical, surgical, and legal interventions.
  • Write affirming, strengths-based letters of support that meet clinical, legal, and insurance requirements while centering client autonomy.
  • Identify and address barriers (systemic, legal, institutional) to access, and employ advocacy strategies in documentation and communication.

Week 16: Advanced Clinical Considerations

Summary:

  • Co-occurring conditions: Disordered eating, autism.
  • Adapting care based on unique client needs.
  • Clinical models for affirming care.

Agenda:

  • Case studies: Assessment and treatment for TGD clients with eating disorders, neurodivergence (especially autism), and other co-occurring mental health concerns.
  • Exploration of the Gender Freedom Model and Gender-Affirming Lifespan Approach, contrasting these with dysphoria-only models; application to diverse clinical populations.
  • Practice: Adapting communication and therapeutic settings for neurodivergent clients.
  • Review: Screening/diagnostic considerations, multidisciplinary care, managing clinical uncertainty, and avoiding gatekeeping.
  • Discussion: Clinical pitfalls (e.g., over-pathologization, bias), supporting nonbinary and nontraditional pathways, and facilitators for care across systems (schools, families, medical teams).

Educational Goal:
Equip clinicians with advanced skills to provide individualized, affirming, and flexible care for trans and gender-diverse clients with complex presentations—including eating disorders, neurodivergence, and experiences outside binary clinical models.

Learning Objectives:

  • Assess and treat co-occurring presentations (e.g., eating disorders, autism) in TGD clients using trauma-informed, person-centered, and affirming approaches.
  • Integrate the Gender Freedom Model and Gender-Affirming Lifespan Approach to guide care beyond dysphoria-centric frameworks, supporting client autonomy and diverse experiences.
  • Adapt clinical interventions, settings, and systems navigation for neurodivergent and multiply-marginalized TGD clients.

Week 17: Advanced Ethics: Power, Politics, and Autonomy

Summary:

  • Critical engagement with complex clinical, legal, and ethical dilemmas.
  • The broader impacts of personal, professional, and institutional power, systemic bias, and the ongoing politicization of trans health.
  • Strategies for ethical decision-making.
  • Advanced approaches to suicidality.

Agenda:

  • Case discussions: involuntary hospitalization and alternatives when working with suicidal or at-risk TGD clients; balancing legal, ethical, and clinical obligations.
  • Review: core ethical principles (autonomy, beneficence, nonmaleficence, justice, fidelity).
  • Exploration: professional codes of ethics (APA, NASW, WPATH), policies, and navigating recent legislative shifts.
  • Controversies: impact of anti-trans legislation, mandated reporting duties, “conscientious objection,” and institutional/structural barriers.
  • Alternatives to involuntary treatment/hospitalization.
  • Activities: vignettes, care plan.

Educational Goal:
Prepare clinicians to thoughtfully identify, analyze, and ethically navigate multifaceted challenges in gender-affirming care—centering client self-determination, safety, and transparency when responding to suicidality, institutional barriers, and real-world ethical grey areas.

Learning Objectives:

  • Apply ethical principles and professional codes to real-world dilemmas in gender-affirming care—especially regarding involuntary hospitalization, suicidality, and institutional/legislative conflicts.
  • Identify and address moral distress when supporting TGD clients at risk for self-harm or subject to involuntary intervention, employing alternatives and transparent frameworks for decision-making and repair.
  • Utilize advocacy, collaborative and harm-reduction strategies to support client autonomy, rights, and safety—particularly when navigating politicized, restrictive, or hostile environments.