Ethical Considerations: Transgender Student Case Study Report

This report analyzes the ethical dilemmas and potential issues a social worker might face when working with a 14-year-old transgender student sent home from school for wearing a uniform inconsistent with their gender identity as recorded in enrollment. The report explores the importance of therapist awareness, available resources, and the provision of support. It highlights the application of ethical decision-making frameworks, specifically human rights and virtue ethics, to guide the social worker's approach. The report emphasizes the need for sensitivity training, advocacy, and continuous learning about the transgender community. It discusses the significance of understanding gender identity, gender expression, and sexual orientation, as well as the importance of maintaining the client's privacy and putting the child at the center of their own story. The report also examines the relationship between human rights and virtue ethics in consulting transgender youth and their families, stressing the well-being of the child above societal reactions. References to relevant literature are also included.

Running head: INTERNATIONAL SOCIAL WORK
International Social Work
Name of Student:
Name of the University:
Author note:

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Chosen Scenario:
A 14 year old transgender student sent home from school for wearing a ‘girls’ school
uniform when the enrolment record shows their gender as male.
Potential Issues and Ethical Dilemmas:
1. Awareness of the Therapist
The therapist working with the young child needs to have comprehensive knowledge
about the treatment protocols and the procedures that are related to the effective treatment
of the individual who is transgender (Chen & Simons, 2018). The World Professional
Association for Transgender Health (WPATH) provides the basic Standard of Care to be
used by social workers or therapists in being able to help them in working with
transsexuals (Knudson et al., 2018). If the 14 year old in the chosen scenario is interested
in gender-transition, the therapists who are working with these children need to be able to
provide a very extensive clinical resources to assist the patients in the treatment.
2. Awareness of the Available Resources by the Therapist
It is very important for the therapist who is working with the child, or with any other
transgender patient, to be aware of the resources that are available in the community. In
example, the therapist needs to be aware of any of the referral contacts for
endocrinologists and other psychiatrists, if the therapist themselves are not being able to
help to their maximum ability (Crall & Jackson, 2016). In addition to providing mental
support to the child who is going through the ordeal of not being accepted in his true
identity, it is equally important for the therapist to engage with the parents in the same
way to give them a peace of mind. The therapists need to make sure that the whole
situation is not an isolated experience for the child and the parents, because hearing the

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stories of other transgender youth and their families will feel validating for everyone in
the family to proceed towards acceptance. Through the awareness of support groups by
the therapists, the youth who are struggling with identity along with the parents can have
a chance to openly talk in a safe environment.
3. Therapist Providing Support
More often than not, transgender youth are being forced to function in a society that
does not truly understand or support their transgender identity. This is where the role of
the therapist comes in where they are able to advocate for their client and their family.
Advocating can simply mean educating within the systems so to make sure that their
clients are able to be treated with an increased level of care and consideration for their
situation. Therapists, along with school staff and teachers, need to undertake sensitivity
training so that they can understand the unique needs of the transgender youth, which is
what results in discrimination against transgender children (Wright, Candy & King,
2018). Not providing the right kind and amount of emotional support to a child who is
still going through his adolescent phase can have great negative impacts on the mental
state of the individual in the long term.
4. Therapist being up-to-Date
For a therapist consulting a child who is transgender, it will definitely have to be a
long-term agreement between them because constant and sudden change for children can
negatively impact their mental state (Chen & Simmons, 2018). Due to this, it is important
for the therapist to be proactive in continuously putting in effort to acquire knowledge of
the subject, related research and literature along with the present social issues that the
transgender communities are facing in all walks of life, and also for all ages. It is true that
there is only a limited amount of scholarly resources available for the topic of

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transgender, but that is also one of the main reasons as to why it is ever evolving. The
transgender community has been heavily impacted by discrimination in society and
resulting oppression, and this is why it is important for the therapist to make themselves
aware of the socio-political forces that are in play in the society: gender construction,
transgender liberation movement and the issues involved in it, and then finally, the wide
range through which gender can be expressed by individuals.
Ethical Decision Making Framework
I. Human Rights
The most important and difficult task that is faced by parents is how they can provide the
best support possible for their children, while maintaining some boundaries and a proper
structure that will help them grow and become responsible adults. It is a fact that children are
always testing the boundaries that are set for them by their parents, but it will be important
for the parents to distinguish between instances where “kids are being kids” and other
instances where the child is doing things that will be portraying critical elements to their
identity and subsequent development of that identity into their adolescent and adult life.
Being aware of one’s gender identity and expression is important for the way an individual
sees themselves and engage with the world around them (Blank, 2018).
In the case in question, the first step for a social worker who wants to make decision
based on human rights, will be to fully understand the meaning of transgender. It is true that
one cannot apply the same consulting techniques on a transgender person and a gender-
conforming person because it is important for the therapist to know the distinct difference
between gender identity, gender expression and also, the individual’s sexual orientation
(McCann & Sharek, 2016). Categorizing people into boxes of groups will not be helpful
when trying to consult a child who is not being able to fully realize what is happening to

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them. For example, the therapist dealing with the child will need to first ensure what pronoun
they would want the therapist to refer to them with, in order to ensure that there are no
harmful assumptions being made.
After understanding the child’s identity as much as can be analysed, it is then important to
proceed on to the next step of guidance which is the process of transitioning. Since the young
boy in question had worn the girls’ uniform to school, it will be important to find out what
they want their true gender to be. It will be important for the therapist to ensure that they are
able to be sensitive to the privacy of someone when writing about someone’s process of
transitioning (Bain, Grzanka & Crowe, 2016). It will be important for the therapist to not
reveal any information about the child’s diagnosis because then it could negatively affect the
child’s trust capability.
Even though the process of transition is a significantly important phase in one’s life, it
should not be the most important factor to be stressed on by the therapist as this can make one
feel like they are just a specimen, and erases their personal humanity. It is important for the
therapist to keep in mind to put the child in the centre of their own story, where the context of
their family and their daily life can revolve around it.
II. Virtue Ethics
Virtue ethics is known as a set of ethical beliefs which are for the people to understand
what they should do when there is an ethical dilemma that they are facing. Awareness of
virtue ethics will help an individual in being able to act upon their moral ideals when a
situation like that arises (de Jong, 2017). When a psychologist (i.e. therapist) is not able to
acknowledge the diversity in ethical standards, he or she becomes unable to distinguish
between cultural and ethical values. With the growing diversity among the patients that are

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being seen by therapists today has led to there being an increase in the overall importance of
being able to distinguish between cultural factors in both practice and research.
Even though there are kids who part of the transgender youth community who have
strong support systems in their family and from their social circle, there are also kids who
face conflict from their family and also have negative experiences related to health outcomes
as it is related to the social stigma (Majd, Marksamer & Reyes, 2016). There are almost four
ethical approaches that social workers can adopt when dealing with Trans youth and their
subsequent families – bioethics, ethics based on rights, relational ethics and finally, justice-
doing. When consulting the youth, it is important for the therapist to engage in informed and
consensual processes so the boy and his family are able to understand the options and
allowing them to choose their choice of care along with making sure that these decisions are
not made through coercion (O’Brien et al., 2016). It is the duty of the therapist to maintain
non-maleficence by making sure that they do not harm, while also preventing the subject to
experience any harm.
III. Comparison – Human Rights vs. Virtue Ethics
Both the decision making frameworks described above are very closely related, if not
components of each other. To be able to consult a patient with keeping in mind human right
aspects, the process will be a lot similar for someone when they are using virtue ethics. In
both the frameworks, it will be important for the therapist to handle the humanity and well-
being of the child at a higher priority than how the society is reacting to their change. In this
case, it will be important for the therapist to ensure to the child that what has happened to him
in school is not correct, and that should in no way hamper the way he wants to express
himself.

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References:
Bain, C. L., Grzanka, P. R., & Crowe, B. J. (2016). Toward a queer music therapy: The
implications of queer theory for radically inclusive music therapy. The Arts in
Psychotherapy, 50, 22-33.
Blank, E. (2018). United Nations Human Rights Council.
Chen, D., & Simons, L. (2018). Ethical considerations in fertility preservation for transgender
youth: A case illustration. Clinical practice in pediatric psychology, 6(1), 93.
Crall, C. S., & Jackson, R. K. (2016). Should psychiatrists prescribe gender-affirming
hormone therapy to transgender adolescents?. AMA journal of ethics, 18(11), 1086-
1094.
de Jong, D. (2017). Christian social work education and transgender issues: A faculty
survey. Social Work & Christianity, 44(1/2), 53-71.
Knudson, G., Green, J., Tangpricha, V., Ettner, R., Bouman, W. P., Adrian, T., ... & Karasic,
D. (2018). Identity recognition statement of the world professional association for
transgender health (WPATH). International Journal of Transgenderism, 19(3), 355-
356.
Majd, K., Marksamer, J., & Reyes, C. (2016). Hidden injustice: Lesbian, gay, bisexual and
transgender youth in juvenile courts.
McCann, E., & Sharek, D. (2016). Mental health needs of people who identify as
transgender: A review of the literature. Archives of psychiatric nursing, 30(2), 280-
285.

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Wright, T., Candy, B., & King, M. (2018). Conversion therapies and access to transition-
related healthcare in transgender people: a narrative systematic review. BMJ
open, 8(12), e022425.