Clinical Services

Philosophical Approach

My approach to working with gender diverse youth and adults is affirming, balanced, and developmentally informed. I believe that every individual knows themselves and should be affirmed in their identity. I also trust the research on child and adolescent development and understand that these are complex stages that require a thoughtful and nuanced approach to fully appreciate each individual child, along with their family and the other contexts in which they live. My approach to therapy and assessment with children and adolescents is affirming and supportive, client and family centered, comprehensive, and developmentally informed. I always involve parents in the process, as research shows that gender diverse youth do best when they have the support of their parents. I also believe that parents’ have an important perspective that needs to be understood and incorporated into the conceptualization of each child’s unique circumstance. I believe the most affirming approach to working with gender diverse youth is comprehensive, individualized, developmentally informed, balanced, and thoughtful.

The Affirming, Developmentally-Informed Assessment Process

The goal of the comprehensive assessment process that I have developed is to better understand the individual child or adolescent in an effort to make recommendations for treatment, including mental health support and/or medical interventions, as well as advocacy. The treatment plan is done in a collaborative manner during a feedback session in which the results from the assessment are shared and recommendations are discussed with the youth and parents. An additional goal of the assessment process is to provide education to youth and their parents about gender identity and diversity, various forms of transitioning, typical processes/protocols, and the available medical interventions. I have provided comprehensive assessments for hundreds of youth and the feedback regarding the assessment process from youth and their parents has been overwhelmingly positive. The comprehensive report that is provided following the feedback session is extremely valuable to the youth, parents, as well as other providers involved in the youth’s care.

What to expect During the Assessment

Historically, mental health providers were expected to be “gate-keepers” for transgender adults seeking medically necessary interventions. Fortunately, the medical and mental health fields have evolved a great deal since that time and I have played a role in helping to create the current clinical guidelines and standards of care which state that mental health providers should be affirming, supportive, and culturally sensitive to the needs of gender diverse individuals. However, due to the historical role mental health providers have played, it is understandable that some individuals may experience hesitation, anxiety, or even fear about seeing a mental health provider for an assessment. It is important for any prospective clients and families to know that I strive to provide a supportive, affirming, and collaborative assessment process. The goal is not for me to determine an individual’s identity (as only the individual knows that), but to provide education and guidance regarding the most helpful, affirming, and safest treatment plan for each individual client. 

The actual assessment typically occurs in one 4-hour visit, as this has been the overwhelming preference of the youth and families with whom I have worked over the last decade. The first part of the appointment is spent with the youth and parents/caregivers going over paperwork and basic background information. The next 1.5-2 hours is spent with the youth, while the parents complete several psychosocial forms in the waiting room. Following this, time is spent with the parents, while the youth completes forms in the waiting room. The last 5-10 minutes are spent with youth and parents together, wrapping up and discussing the next steps.

The information obtained during the assessment process includes the following: gender identity development/history; transition-related goals (e.g., medical interventions, social transition steps); discussion of expectations for any medical interventions being sought to ensure that the youth and parents have accurate information and realistic expectations; information about family relationships and dynamics; social/peer support; academic/school history and support related to gender identity; general strengths and interests; early developmental milestones; and mental health concerns historically and currently.

All of the information obtained during the clinical interview and from the forms completed by the youth and parents is then integrated into a comprehensive report. The family typically returns for a feedback session 1-2 months after the evaluation appointment, and the comprehensive report is mailed to the family, and any other providers requested by the youth and parents, soon after.

I am happy to answer any additional questions about my philosophical approach and the assessment process via email.