Judith Leitch

Introduction and BackgroundThe 47th U.S. presidential administration has both reflected and intensified political hostility toward transgender and nonbinary people through targeted policies and rhetoric. While previous research has documented the psychological harm caused by sociopolitical hostility, less is known about how transgender and nonbinary communities interpret, endure, and make meaning within the context of sustained systemic threat. This conceptual model integrates theory and lived experience to articulate patterns of emotional and behavioral response; this can inform advocacy, care practices, and policy interventions during periods of heightened vulnerability.Theoretical FramingThis conceptual model developed through situated theorizing based on the author's roles as clinician, community member, and researcher. Drawing from Minority Stress Theory, the Social Safety Model, and theories of trauma, grief, and critical frameworks, the model describes how transgender and nonbinary people navigated the first 100 days of the administration.Model OverviewThe model consists of three recursive phases: Rupture, Mobilization and Inactivation, and Containing Harm, Creating Safety. These phases reflect layered patterns of meaning-making, including initial collapse, cycles of action and inaction, and strategies of emotional containment and refusal.Discussion, Conclusions, and ImplicationsThis model offers a process-based framework for understanding psychological and relational responses to systemic threat. It supports trauma-informed, grief-responsive, and justice-oriented approaches in clinical, research, and policy settings. Finally, it highlights how harm can be mitigated and care sustained when safety cannot be externally guaranteed.

BackgroundThis qualitative study inductively draws on interviews with transgender and gender nonconforming (TGNC) people about positive emotional experiences related to their TGNC identities. Applying grounded theory tradition, this study provides an understanding of TGNC people's pathways to gender fulfillment and euphoria and presents a positive framework to understand TGNC gender experiences.MethodsResearchers analyzed data from semi-structured virtual interviews conducted with a diverse sample of 36 participants, including TGNC people and mental health providers working with the TGNC community. Researchers gathered data using three distinct semi-structured interview guides eliciting information about TGNC gender experiences, mental health, euphoria, and joy. Data were analyzed using a grounded theory approach; member checking and peer debriefing were conducted to ensure the credibility and trustworthiness of the findings.ResultsThe study identifies a cyclical framework for TGNC identity manifestation, consisting of Identity Exploration, Identity Awareness, Identity Enactment, and Identity Assessment. Gender euphoria is a dynamic experience that may be felt during any part of the cycle; it is a short-term response to a positive, novel experience of identity. TGNC people may also experience Gender Fulfillment, Gender, Contentment, Gender Frustration, and Gender Depression as outcomes relating to their gender experience.Discussion & ImplicationsStudy findings highlight the range of positive experiences of TGNC identity, which may be outcomes of Identity Enactment and experienced throughout the identity cycle. Findings highlight differentiations among positive feelings and related stimuli. This research improves our clinical understanding of TGNC experiences and provide a positive framework for future research.

Youths’ perspectives, unique from adults, are shaped by their developmental experiences. This study contextualizes the meaning of mental health and being mentally healthy from adolescent perspectives. Four focus groups of students in grades 9 to 12 ( N = 27) were recruited from a school in an urban city. Participants were mainly female ( n = 22) and majority students of color (e.g., Black/African American, Hispanic/Latinx; n = 21). Researchers interpreted the data through a pragmatic lens. Three main themes emerged: Describing Mental Health, Defining Mentally Healthy, and Integrating the Role of Social Environments. Two subthemes were also identified. The study highlights the significance of including youth contributions in defining terms such as mental health and being mentally healthy and underscores the importance of the environmental context to youth’s conceptualization of mental health, with a focus on resiliency-building factors. Findings have applicability for incorporating youth voice in interventions designed to improve youth mental health and foster positive youth development.

This paper argues for the application of Intersectional Feminist theoretical lens to social work pedagogy and provides sample educational activities, from simple to complex, which apply this lens to bachelors, masters, and doctoral social work levels. All social workers must be prepared to work effectively with transgender and gender nonconforming (TGNC) people. This work relies on social workers' knowledge, skills, and self-awareness. Social workers who lack knowledge, skills, and self-awareness of the dimensions of gender diversity can create barriers to care for TGNC people. Increasingly, research on social work education and professional social work organizations are encouraging and expanding guidelines for effective practices with TGNC people. Much of this guidance stresses discrete practices rather than situating practice within a broader theoretical framework. Rather than adding to general guidance, we advocate for the application of an Intersectional Feminist lens in teaching social workers dimensions of gender diversity. Applying an Intersectional Feminist lens to social work education creates a context to frame educational activities and facilitates students' self-discovery of personally and socially held conceptions and biases related to gender. We include activities to help those teaching social work infuse this lens into pedagogy across levels of teaching social work.

Sexual and gender minority (SGM) people use therapists at high rates, emphasizing the importance of understanding of clinical practice behaviors and drivers of practice behaviors with these clients. Data were collected from social workers approved as Field Instructors at a Mid-Atlantic university (N = 198) via web-based surveys. Data themes are Beliefs About Practice with SGM Clients; Beliefs About SGM Clients' Stressors, Shame, and Safety; Reported External Barriers to Practice with SGM Clients; and Reported Personal Barriers to Practice with SGM Clients. Themes highlight the importance of personal beliefs and provide details on barriers to effective practices.

Psychotherapy research often centers therapists' perspectives, and thus there is minimal exigent research on selection of or engagement with practice from the client perspective, limiting therapists' ability to incorporate the client's perspective into treatment. This is particularly relevant for clients with marginalized identities, like lesbian, gay, bisexual, transgender, and queer (LGBTQ) people, whose experiences of oppression may mediate the therapist selection and engagement process. This article proposes a six-stage model describing LGBTQ clients' process of selection of and engagement with therapists. This model emphasizes the importance of client and therapist identities and identity-congruence, therapist's self-reported treatment modalities, and the effects of system-level barriers, such as costs, in mental health care. Awareness of these factors enables therapists to anticipate clients' needs, potentially increasing the effectiveness of care.

People who are transgender and gender nonconforming (TGNC) have substantial disparities in mental health and thus rely on mental health practitioners like therapists to help address these disparities. However, little is known about therapist practices with TGNC people, and what research exists is often generalised from broader research on practice with people who are gay and lesbian. Because this research uses broad models to describe practitioner behaviour, it assumes all therapists approach practice with TGNC clients in the same way. The current study explores therapists' self-reported practices with TGNC people through a structured, qualitative, web-based survey of 95 practising social workers. From a thematic analysis of responses, five approaches to practice with TGNC people emerged: 1) A Low-Impact Approach, 2) A Fairness First Approach, 3) A Responsive Approach, 4) A Therapist Responsibility Approach and 5) A Pathological Approach. These approaches vary on three key dimensions: whose responsibility it is to broach client gender identity in treatment (therapist or client), the importance of gender identity (from low to high), and whether a TGNC identity is a disorder (yes, no or not addressed). The breadth of practice behaviours and undergirding assumptions participants described indicates that a single model may not fit practice behaviour with TGNC people. A discussion of the relationship between each approach and existing practice models suggests that the Low-Impact Approach, Responsive Approach and Therapist Responsibility Approach may be effective with TGNC people and that the Pathological Approach likely represents poor practice.

Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (
= 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.

COVID-19's unprecedented effects on the world emphasize the minimal exigent research on best practices of social work pedagogy during crises. The purpose of this paper is to inform this research and our understanding of social work education's shift at the beginning of the COVID-19 pandemic. This study draws upon the narratives of four key stakeholders in the educational process: a graduating MSW student, a field director, an adjunct faculty member (already teaching online), and a tenured faculty member who had never taught online. An inductive thematic analysis of these stakeholders' narratives highlights the intersection of the personal and the professional in social work education, illustrates concerns about power relationships and self-disclosure, and considers equitable learning in the context of the pandemic. Special attention is paid to the start of online teaching and learning. Recommendations highlight the importance of awareness of both student and educator perspectives in adapting social work pedagogy during a crisis. These recommendations may also be applied more broadly, particularly to the burgeoning use of an online social work education format.

This study introduces a new instrument designed to assess affirmative clinical practices with sexual and gender minority (SGM) clients, the Lesbian, Gay, Bisexual, and Transgender Competency Assessment Tool (LGBT-CAT). The LGBT-CAT has two unique qualities: Its design enables adaptation to measure practice competencies with gay, lesbian, bisexual and/or transgender clients, the latter of which has no existing measures regarding practice competencies, and it uses a qualitative collection method. Participants respond to 12 open-ended prompts; responses are then quantified by one or more raters based on a scoring rubric. In this cross-sectional study, practicing social workers (N = 357) were surveyed using the LGBT-CAT as well as measures of affirmative practices with SGM clients, knowledge, beliefs, self-efficacy skills, attitudes, and behaviors. The LGBT-CAT demonstrated good reliability, poor criterion validity, and adequate construct validity. These results support the potential integration of the LGBT-CAT into research on practice with SGM clients.