Background

In May 2018 the Department for Education (DfE) published a research report looking at the issue of Transgender Awareness in Child and Family Social Work. The research was commissioned as part of a wider Government programme looking at ways to reduce the inequality and discrimination which transgender people experience.

In a bid to lessen discrimination and transphobia, the Government has committed to ensuring that all public sector workers – including social workers – receive training on issues of gender identity and gender variance. This research is intended as a starting point to enable the DfE to better understand the adequacy and consistency of current social work training and education around transgender issues, and to identify whether additional training needs to made available in the future.

Methods

The research comprised 3 stages:

• A rapid evidence review to look at the density and quality of evidence on social worker education in regard to gender identity and gender variance;
• A content analysis looking at the content of social work courses provided by Higher Education Institutions in England; and
• Semi-structured interviews with stakeholders in social work education; representatives of organisations that provide support to the transgender community; representatives of institutions that provide qualifying and post-qualifying courses in social work; and representatives of child and family social work teams working within local authorities across England.

Findings

Rapid Evidence Review – The review identified a significant lack of transgender-specific social work research. On the basis of the limited research findings available, the evidence suggests that transgender people commonly report having poor experiences within social and care settings. More specifically, evidence suggests childhood gender dysphoria remains poorly understood by social workers, resulting in transgender people experiencing discrimination and gaps in services.

Available research covering transgender peoples’ experiences of services highlight that many professionals lack appropriate information about transgender peoples’ general needs, and that professionals can sometimes be insensitive to the needs of transgender service users, partly due to a failure to accept their acquired gender.

Some evidence suggests childhood gender dysphoria remains poorly understood by social workers, and that parents and children often find themselves having to educate the professionals around them. There was also evidence to suggest that transgender people have problems being approved as potential foster carers or adoptive parents.

Content of Social Work Courses – The research found little explicit reference to gender identity and gender variance within both undergraduate and postgraduate social work courses in England. The analysis of course content identified that transgender issues may however be covered implicitly, through references to broader issues such as equality and diversity, as well as anti-discriminatory principles and practices.

Interviews – Interviews with stakeholders identified that transgender people typically have poor experiences when in contact with child and family social services. Examples included social workers behaving in a prejudicial manner, labelling parental support of gender variance as abuse, failing to recognise risks associated with an unsupportive home environment, and making uniformed judgements around the acceptance of gender variance. However the interviews did uncover examples of more positive experiences, with stakeholders recognising some social workers as playing a key role in family mediation, being a key resource of information, facilitating treatment pathways and support, tackling local discrimination and generally ensuring that the interests of gender-variant children and young people are best promoted.

The range and diversity of views and experiences collected through the interviews suggest that child and family social workers’ knowledge of transgender issues is very mixed. Whereas some child and family social workers would seem to have minimal awareness of transgender issues, others operate within pockets of expertise, characterised by specialised knowledge and good practice.

The interviews highlighted that very few social workers have had specific education or training in relation to transgender issues, either at qualifying or post-qualifying level. Of those that do, transgender issues tended to be subsumed under the LGBT umbrella, resulting in a lack of specificity in education.

Competing Priorities?

Interviews with transgender stakeholders described the rapidly growing prevalence of gender variance within the UK; despite this, all representatives of local authorities who took part in the research described gender variance as an issue that their services rarely encountered.

Interviewees across local authorities and education institutions consistently referred to gender variance as a minority issue. One possible reason for this could be that gender identity is not, in itself, a social work issue. However the vulnerabilities that often surround transgender experiences, in combination with initial reasons for service involvement, make the role of social workers incredibly important.

“It’s getting that balance correct that you want to be helpful and supportive if parents or carers aren’t responding positively then there may well be a need for the social worker to do something around that, In itself, a child questioning their gender identity isn’t a social worker’s issue, and I think that needs to be recognised.” [Higher Education Institution]

“Amongst the trans children in the population there’s only a very small number that will come the way of social workers. But, nevertheless, it is likely these young people will be in particularly vulnerable situations, so they’re exploring their gender identity in the context of having parents perhaps with mental health or drug issues, potentially in situations of abuse and neglect and so on.” [Social Worker Education Stakeholder]

Furthermore, other more pertinent training issues were described as consistently taking priority, often in response to arising core safeguarding issues.

“I would say we generally go through phases. I know that sounds awful, so you had FGM, you had CSE. I would say there’s a lot more radicalisation, we’ve all had radicalisation training and I think they do go with themes of the time, and it is often as a response to something rather than pre sought out.” [Local Authority]

Furthermore, a decline in resources was consistently described by local authorities as a fundamental barrier to investing in training to promote transgender awareness.

“So it is about prevalence and it’s about money, you know. We’re struggling to provide the training on all the bigger topics that people are more likely to come across as it is, without narrowing quite expensive training into more minority areas.” [Local Authority]

“For me the struggle is always what to prioritise within a curriculum that is ever-changing and is increasingly crowded you know with the kind of policy change and having to respond to that. There’s always the dilemma for us, an emphasis on providing foundational knowledge and skills and awareness that then is tailored to the needs of very specific populations.” [Higher Education Institution]

Social Worker Led Research

Social workers who identified themselves as having minimal education and training on transgender issues described undertaking their own research in order to better support gender variant young people and their families.

“I spent a lot of Googling I have to say… unfortunately for [service user] it’s very trial and error, some things will work, some things won’t work, but yeah, no unfortunately the internet’s been my main port of call.” [Local Authority]

“I know this from personal experience, that we’ve got one young person who’s looked after who is going through a transition, and so for the staff who’ve been working with that young person they themselves have sort of done some research and we’ve had some advice, but that’s been very much about that young person as opposed to a broader approach in terms of training to the whole staff group.” [Local Authority]

Recommendations

• Due to the current low prioritisation of gender variance within the profession, leadership (including from the DfE and Chief Social Workers) will be crucial in not only raising the profile of transgender awareness, but also engendering change;
• Transgender awareness is an area in need of development across the social work profession, with the evidence clearly indicating a demand for additional training materials. The threshold of required knowledge could be relatively low, and simply becoming conversant with the core issues surrounding gender identity would greatly assist social workers in providing supportive services;
• Gender identity issues should be incorporated into the social work curriculum in order to combat the limited knowledge or training of social workers;
• Training for existing workers should help them understand  the importance of confidentiality and the use of gender-neutral language and/or language that reflects services users’ own terminology;
• Resources provided to social workers could take many forms, including e-learning, toolkits and good practice guides. There is however a need to avoid resources and expertise continuing to be trapped amongst individuals and within localities;
• With appropriate training and knowledge, social workers can be pivotal in providing a supportive framework to support young people and their families to explore issues around gender variance.

Examples of Good Practice

• Service user-led sessions on transgender issues, led by a transgender person;
• Covering transgender issues in regard to equality law;
• Sessions on effective communication with children, including coverage of transgender issues;
• Teaching on child development, including gender variance;
• ASYE training on sexual and gender identity;
• Outsourced specialist training covering referrals and treatment;
• Safeguarding, with particular reference to vulnerabilities associated with gender variance.

Glossary

Gender dysphoria is a condition where a person experiences discomfort or distress due to a mismatch between their biological sex and gender identity.

Gender identity is a term used to describe an individual’s sense of their own gender. For transgender people, their gender identity does not match the sex they were assigned at birth.

Gender variance is a term used to describe behaviour or gender expression by an individual that does not match conventional constructs of gender.

Transgender is an umbrella term used to describe people whose gender identity and/or gender expression differs from their sex assigned at birth.

Transphobia is a range of negative attitudes and feelings toward transgender people.

Further Information

• Gender Identity Issues (tri.x Briefing 189, November 2016)
  http://www.trixonline.co.uk/website/news/pdf/policy_briefing_No-189.pdf
• Mermaids – A support for gender variant children, teenagers and their families https://www.mermaidsuk.org.uk/; including information and resources for professionals https://www.mermaidsuk.org.uk/professionals/
• Gender Trust – advice for those affected by gender identity issues
  http://www.gendertrust.org.uk/
• NHS – Gender Dysphoria
  https://www.nhs.uk/conditions/gender-dysphoria