XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

The Los Angeles Gender Center Approach to Psychological Evaluation and Treatment of Gender Identity Disorder

Keller, Marie, MFCC; Ring, Arlen, Ph.D.; Vollmer, Shirah, MD; Turen, Elise, MA; Silvestri, Amanda, MA; Milrod, Christine, MA

Los Angeles Gender Center, 1923-1/2 Westwood Blvd., Suite 2, Los Angeles, California, USA 90025

The Los Angeles Gender Center occupies the space between the individual private practice Mental Health Professional and the institutionally located MHP. It is a multidisciplinary group of six MHP gender specialists who have developed a strong team approach to working with individuals who are transgendered. We have resources greater than those available to an individual practitioner and we have flexibility greater than generally found in an institution. The LAGC has developed tools and procedures which could be adopted by other MHP’s.

One of the LAGC’s greatest strengths is that, through the integration of assessment, psychotherapy and psychopharmacology, we are able to accommodate clients who have multiple diagnoses. Individuals who are appropriate candidates for sex reassignment surgery, but who have multiple psychological difficulties can seem overwhelming to a sole practitioner. They may be classified as having too much psychopathology to proceed forward with hormone therapy or SRS. Clients such as these have received treatment for their disorders as well as support for their transitions and have had successful outcomes at the LAGC.

One tool we have developed, the Clinical Issues Checklist, would be applicable for MHPs at any level of organization from individual to institutional. The checklist serves as a screening device, a safeguard against misdiagnosis, a basis for clinical intervention, a reference point for progress and a foundation for communication among professional. Eventually it serves as the basis for the recommendation letter required by physicians who adhere to the Standards of Care.

In addition to assessment, psychotherapy, and letters of recommendation for the endocrinologist and surgeon, the LAGC provides a number of other services. The range and choice of these services are guided by our belief that the struggle to establish a dignified and secure place in society is an integral part of the treatment of transgendered persons. We attempt to raise the level of accurate information and acceptance in society in order to combat stigmatization. We act as consultants to employers and to MHPs, mental health agencies and social service agencies who are less familiar with the transgendered population. We stay aware of ethical, competent, outside support services to whom we refer our clients.

We sponsor monthly community events with speakers and topics of interest to the community. These events provide useful information as well as opportunities to gather and feel a part of a welcoming, caring environment. We have ongoing support groups for people who are in transition, people who are undecided and exploring their options, and for couples. Since we have an ethnically diverse population we address multicultural issues. We are currently developing support services for children of transsexuals. In general, we try to address both social and psychological issues.