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ACS is committed to creating a safe and affirming environment where all young people can thrive, no matter their sexual orientation or gender-identity and expression. The ACS Office of LGBTQ Child and Family Well-Being raises awareness and helps make sure that all of our services are affirming of LGBTQ (lesbian, gay, bisexual, transgender, and questioning) youth and families.

In the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people whose gender at birth is contrary to the one they identify with will be diagnosed with gender dysphoria. This diagnosis is a revision of DSM-IV’s criteria for gender identity disorder and is intended to better characterize the experiences of affected children, adolescents, and adults.

What does transgender mean?

According to the APA Style guide, the term “transsexual” is largely outdated, but some people identify with it; this term should be used only for an individual who specifically claims it. While the term “transsexual” appears multiple times throughout this document, APA’s Committee on Sexual Orientation and Gender Diversity is undertaking a systematic review of its use along with other terms. In the meantime, please refer to the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (PDF, 472KB) for more up-to-date language regarding transgender and gender nonconforming people.

Transgender is an umbrella term for persons whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Gender identity refers to a person’s internal sense of being male, female or something else; gender expression refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice or body characteristics. “Trans” is sometimes used as shorthand for “transgender.” While transgender is generally a good term to use, not everyone whose appearance or behavior is gender-nonconforming will identify as a transgender person. The ways that transgender people are talked about in popular culture, academia and science are constantly changing, particularly as individuals’ awareness, knowledge and openness about transgender people and their experiences grow.

"This publication sets forth guidelines to address the needs of transgender and gender non-conforming employees and clarifies how the law should be implemented in situations where questions may arise about how to protect the legal rights or safety of all employees. These guidelines do not anticipate every situation that might occur with respect to transgender or gender non-conforming employees, and the needs of each employee must be assessed on a case-by-case basis. In all cases, the goal is to ensure the safety and comfort of transgender or gender non-conforming employees while maximizing the employee’s workplace integration and minimizing stigmatization of the employee" (p. 3). Sections of this guide cover: purpose; definitions; privacy; official records; names and pronouns; restroom accessibility; locker room accessibility; dress codes; transitioning to the job; sex-segregated job assignments; discrimination and harassment; additional resources; and Unit of Assignment (UOA) Transition Plan Guide—before the UOA transition begins, the day the transition will be made known to co-workers, and the first day of the employee's official workplace transition.

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“For adolescents, developing and integrating their identity can be difficult. For gay and lesbian youth, this task is greatly complicated because they must integrate an identity that diverges from mainstream society … Gay and lesbian youth need help resolving adolescent identity crises” (p. 1). This article provides guidance for out-of-home care professionals in supporting gay and lesbian youth as they figure out who they are going to be. Best practices tend to cluster around three areas: vulnerability versus empowerment—using inclusive language (being aware of heterosexist bias), picking up on hints that youth may not be heterosexual, mediating with others as youth work things out, respecting the privacy of youth, and if you don’t normally make a formal note of a youth’s heterosexuality do not mention a youth’s homosexuality; stigmatization versus validation—individualizing messages, affirming the youth, reframing differences as unique traits, nurturing the youths’ pride, and making sure the youth are seen as normal; and acceptance versus rejection—welcoming, being engaged with the youth, keeping an open mind, connecting youth with other gay and lesbian youth, and reflecting rather than instructing.

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"The term [cultural competency training] has been used interchangeably with diversity education, cultural sensitivity training and multi-cultural workshops. Cultural competency is commonly understood as a set of congruent behaviors, knowledge, attitudes and policies that enable effective work in cross-cultural situations. Cultural competency training, therefore, aims to increase knowledge and skills to improve one’s ability to effectively interact with different cultural groups" (p. 5). This document explains how to effectively develop and deliver LGBTQ (lesbian, gay, bisexual, transgender, and questioning) cultural competency training. While it is intended for health and social service agencies, it is equally applicable to correctional agencies. Sections of this document include: introduction; defining cultural competency training; goals of LGBTQ cultural competency training—goals vs. objectives; preparing for a training—six trainer skills; training components—core topics; pros and cons of the following training methods—lecture with PowerPoint slides, guest speaker(s)/ panel discussion, media, interactive participation, print materials and learning aids, and Web-based learning; training evaluation—Kirkpatrick Model (Pyramid) of Learning, and Evaluation Planning Chart; resources and examples; and evaluation appendix—Kirkpatrick's Model of Evaluation is detail, tips on evaluation, sample training fidelity list items, sample survey items, and demographics.

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This is an excellent report explaining how “school climate has a profound impact on the mental, physical, and emotional health of LGBT [lesbian, gay, bisexual, and transgender] students and is a crucial factor in pushing these students out of school and into the juvenile justice system … Hostile school climate perpetuates higher rates of truancy, absenteeism, and dropping out for LGBT youth, heightening the risk of arrest for those students already particularly susceptible” (p. 6). LGBT youth make up 5-7% of the total youth population. Yet, 15% of youth in the juvenile justice system are LGBT. Sections of this report are: introduction and summary; the school-to-prison pipeline defined; hostile school climates push students out of schools; examining factors that contribute to hostile school climates—peer-on-peer bullying, dress codes and monitoring of student behavior, unenumerated policies, and lack of access to LGBT resources; harsh school discipline policies criminalize youth—zero-tolerance policies and the policing of students, and disparate application of discipline policies lead to increased suspensions, expulsions, and arrests; and alternatives to harsh discipline policies—Supportive School Discipline Initiative (SSDI), and jurisdictional responses to school discipline.

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“[D]espite some recent advances in understanding and acceptance, LGBT [lesbian, gay, bisexual, and transgender] individuals remain subject to the traumas of negative stereotyping, rejection, marginalization, and discrimination—all of which impede help-seeking behaviors. To compound the problem, LGBT individuals with mental health problems, addictions, or both, may experience additional forms of prejudice and discrimination related to each of those conditions … SAMHSA [Substance Abuse and Mental Health Services Administration] convened the dialogue to develop and/or enhance partnerships among people in recovery, to identify specific factors at the individual and systems levels that can promote or hinder recovery for LGBT individuals, and to help participants gain a better understanding of a variety of perspectives and experiences in advancing recovery for LGBT individuals. In addition, by convening a range of stakeholders to address collaboratively the critical need for improving services, supports, and systems designed to address the mental health and addiction recovery needs of LGBT individuals, SAMHSA anticipated that the suggestions and recommendations summarized in this monograph would serve as a starting point for individuals and organizations interested in taking concrete action to improve recovery opportunities for LGBT individuals. This booklet is comprised of four sections: overview; dialogue themes and findings—eight major themes, personal-level factors that promote or impede recovery, and system and contextual factors that promote or impede recovery; recommendations for action—major and strategic; and milestones in the LGBT mental health consumer movement.

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People who are lesbian, gay, bisexual, or transgender (LGBT) are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the country. The perspectives and needs of LGBT people should be routinely considered in public health efforts to improve the overall health of every person and eliminate health disparities.

Research has shown that lesbian, gay, bisexual, and transgender (LGBT) people face a higher risk of sexual victimization in confinement. Recent Bureau of Justice Statistics surveys found that adults and youth in confinement who identify as lesbian, gay, or bisexual were much more likely to have experienced sexual victimization by another inmate than their heterosexual counterparts.


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