Tips for Working with Transgender Persons

In light of the tragic death of Leelah Alcorn, a transgender teen from the Kings school district, who completed suicide, here are some tips in working with persons who identify as transgender for professionals in clinical settings from SAMHSA:


  • Use the proper pronouns based on their self-identity when talking to/about transgender individuals.
  • Get clinical supervision if you have issues or feelings about working with transgender individuals.
  • Allow transgender clients to continue the use of hormones when they are prescribed. Advocate that the transgender client using “street” hormones get immediate medical care and legally prescribed hormones.
  • Require training on transgender issues for all staff.
  • Find out the sexual orientation of all clients.
  • Allow transgender clients to use bathrooms and showers based on their gender self-identity and gender role.
  • Require all clients and staff to create and maintain a safe environment for all transgender clients. Post a nondiscrimination policy in the waiting room that explicitly includes sexual orientation and gender identity.


  • Call someone who identifies himself as a female he or him or call someone who identifies herself as male she or her.
  • Project your transphobia onto the transgender client or share transphobic comments with other staff or clients.
  • Make the transgender client choose between hormones and treatment and recovery.
  • Make the transgender client educate the staff.
  • Assume transgender women or men are gay.
  • Make transgender individuals living as females use male facilities or transgender individuals living as males use female facilities.
  • Allow staff or clients to make transphobic comments or put transgender clients at risk for physical or sexual abuse or harassment