Rural Department of Allied Health, La Trobe University, Bendigo, Australia.
Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, DC.
Am J Speech Lang Pathol. 2022 Jul 12;31(4):1574-1587. doi: 10.1044/2022_AJSLP-21-00322. Epub 2022 May 17.
Gender dysphoria is commonly conceptualized as a mental disorder in gender-diverse people who do not identify with the gender assigned to them at birth. Direct support for well-being tends to be delegated to the field of mental health (MH), whereas speech-language pathology (SLP) practice is charged with modifying gender-diverse people's voice and communication in the belief that well-being will improve as a byproduct. However, with the introduction of the minority stress model, gender dysphoria is now understood as the result of sociocultural processes of stigmatization, pathologization, coping, and resilience, and it is to be addressed by all professions providing transgender health services. The purposes of this tutorial are to examine practices in SLP in light of the current conceptualization of gender dysphoria and guide speech-language pathologists in their role in supporting the well-being of gender-diverse people.
We reviewed the SLP and MH literature in the topic area to compare the two disciplines' conceptualizations and approaches to professional support for gender-diverse people.
We propose a transdisciplinary, person-centered, and culturally responsive approach to SLP practice that directly attends to minority stress, microaggressions, coping skills, and resilience factors.
It is not sufficient for speech-language pathologists to delegate support for well-being in gender-diverse people to MH practitioners. Rather, speech-language pathologists need to be proactive in taking responsibility for supporting their clients' well-being based on each individual clinician's knowledge, skills, and capacity to do so. We recommend addressing barriers and facilitators of gender-diverse people's well-being both within SLP as a professional culture and by adapting the clinician's own professional practice.
性别焦虑通常被概念化为性别多样化的人所患的一种精神障碍，他们对出生时被分配的性别不认同。幸福感的直接支持往往被委托给心理健康（MH）领域，而言语-语言病理学（SLP）的实践则负责改变性别多样化者的声音和沟通，因为人们相信幸福感会作为副产品而提高。然而，随着少数群体应激模型的引入，性别焦虑现在被理解为污名化、病理化、应对和适应的社会文化过程的结果，所有提供跨性别健康服务的专业人员都应该解决这个问题。本教程的目的是根据当前对性别焦虑的概念化来审视 SLP 的实践，并指导言语语言病理学家在支持性别多样化者的幸福感方面发挥作用。
我们回顾了 SLP 和 MH 文献中该主题领域的内容，以比较这两个学科对性别多样化人群的专业支持的概念化和方法。
我们提出了一种跨学科、以个人为中心、对文化敏感的 SLP 实践方法，直接关注少数群体应激、微侵犯、应对技能和适应因素。
言语语言病理学家将性别多样化者的幸福感支持委托给 MH 从业者是不够的。相反，言语语言病理学家需要根据每个个体临床医生的知识、技能和能力，积极主动地承担起支持客户幸福感的责任。我们建议解决性别多样化者幸福感的障碍和促进因素，既要在 SLP 专业文化内解决，也要适应临床医生自己的专业实践。
