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Guidelines for inclusive volunteer and employee environments for individuals undergoing gender affirmation

AIM:

Our aim is to provide information and resources to support organisations to implement inclusive practices for volunteers or employees who are undergoing transgender hormone therapy or gender-affirming. There are many benefits to an inclusive workplace and this will provide services with information on how to support and provide exceptional inclusive practices for individuals who are undergoing gender-affirming. Within this resource, we also included connections to case studies we conducted of individuals who identify as LGBTQI+.


Content:

  • Introduction
  • Definition of Transgender
  • What is gender-affirming hormone therapy
  • Principles of undergoing gender-affirming hormone therapy
  • Definition of Transitioning genders
  • Implications of identifying as Transgender and gender affirmation
  • Barriers transgender diverse people face
  • Advice for employees and volunteers
  • Barriers services face when supporting individuals who are transitioning genders
  • Advice for services when supporting an individual who is transitioning genders or undergoing transgender hormone therpay
  • Case study: Transcript of questions and personal experiences
  • Links to other relevant resources
  • References

We acknowledge that the trans community is continuing to evolve every day and is richly diverse. To ensure the language used in this resource is appropriate and current we have utilised terminology from the TransHub glossary of terms.

OUR GLOSSARY OF TERMS – TRANSHUB

www.transhub.org.au/language

Definition of Transgender

Trans describes people whose gender differs from what was presumed for them at birth (sometimes referred to as “assigned at birth”), including trans women, trans men, and non-binary people (Thompson, 2015).

Definition of gender affirmation:

‘Affirmation’ refers to the process and/or the period of time during which gender reassignment occurs (with or without medical intervention) (de Vries & Sojka, 2022). Not all people who undertake gender reassignment decide to undergo medical or surgical treatment to alter the body. This period of time is where an individual begins to live according to their gender identity, rather than the sex they were thought to be at birth.

THE DIFFERENT APPROACHES TO TRANSITIONING

www.identiversity.org

What is gender affirming hormone therapy:

The process of taking prescribed gender-affirming hormones for individuals who wish to align their physical body to their identity (Cundill, 2020).

Principles of undergoing gender affirming hormone therapy:

  • The goal of gender-affirming hormone therapy is to align physical appearance with gender identity to reduce distress and improve well-being.
  • Individualised approach to gender-affirming hormone therapy– there is no ‘one size fits all’.
  • Begin with low doses and titrate up gradually.
  • Gender-affirming hormone therapy is usually, but not always, lifelong. Some patients choose to cease hormones once the desired changes have occurred (Cundill, 2020).

Implications of identifying as Transgender and gender afirmation:

– Transgender adults are twice as likely as cisgender adults to be unemployed.

– Cisgender employees make 32 percent more money a year than transgender employees, even when the latter has similar or higher education levels.

– More than half of transgender employees say they are not comfortable being out at work.

-Two-thirds of individuals who identify as transgender remains in the closet in professional interactions outside their own companies.

-People who identify as transgender feel far less supported in the workplace than their cisgender colleagues do.

-They report that it’s more difficult to understand workplace culture and benefits, and harder to get promoted (Stute, 2014).

Barriers individuals gender affirming face:

-Daily workplace discrimination against transpeople leads to increased stress, anxiety, depressive symptoms, post-traumatic stress disorder (PTSD), substance abuse, and suicide—often at higher rates than their lesbian, gay, and bisexual colleagues (Seelman, 2016).

– Broadly, research has found workplace experiences of LGBT employees to be marked by different sets of feeling rules, risk of isolation, fear of termination, and a lack of health care benefits for significant others or family (Bowen & Blackmon, 2003; Williams & Dellinger, 2010).

– Studies of diversity in organisational voice have also identified a vertical “spiral of silence” brought about by the “inability to fully express one’s personal identity within the workgroup because of a negative climate of opinion towards a particular aspect of one’s identity” (Bowen & Blackmon, 2003. As a result, LGBT employees experience simultaneous invisibility and hyper-visibility, which caters to traditional assumptions at the expense of being marked alternative (Dixon & Dougherty, 2014).

-For gender and sexual minorities, revealing one’s core identity might disrupt forces of social cohesion, while staying silent implies reduced self-efficacy and inhibited social and task exchange. (Bowen & Blackmon, 2003).

Case Study:

Our interviewees commented that they constantly worry that people don’t see them as a person because they have separated themself from standard male or female gender identity. They fear annoying their co-workers by trying to remind them of their they/them pronouns which in turn could ruin their relationships. So they don’t speak up about it- which lowers their self-worth which makes them sad, and slows down their progress.

Advice for employees and volunteers:

  1. Flag when you’re struggling
  2. Find community group connections
  3. Find mutual aid projects
  4. Build resilience and improve self-worth with Trans vitality toolkit

1.Steps to Flag Your Issue

There are a few steps you could consider when you’re facing an issue in the workplace and want to flag it professionally and calmly, without causing unrest.

Step 1–definition

Write down the problem and study it to assess if you’re being super sensitive or emotional. After all, there’s a big difference between being treated disrespectfully by a colleague and not liking the tidiness of their desk.

Step 2–examine company policies

Companies should have policies and guidelines readily available to employees. Check if your issue is covered, to confirm you have a real point. Double-check your facts.

Check if your organization has a dispute policy. If it does, read it carefully and follow it, so you don’t become part of the issue.

Step 3–think about potential solutions in advance

Before formally raising an issue, think in advance about sensible, fair, and practical solutions so you’re ready to put them forward to your colleague and/or boss. This will demonstrate you’ve put time into a possible resolution.

When thinking about solutions, consider organisational benefits and costs. Understanding practicalities can provide perspective. Sure, some problems require an investment to fix, but not all do. An open table discussion or a short training session may be a solution, for example, but expecting your boss to reconfigure the office so you don’t have to sit beside a certain colleague likely won’t be.

Step 4–use the suggestion box

If your workplace has an anonymous suggestion box, consider using it. Of course, this might not be appropriate if it’s going to be obvious that it was you who popped the suggestion in the box.

Step 5–have a discussion

If a colleague is causing you a problem, chat with them about it first, to see if the two of you can sort matters out amicably.

Can’t resolve the issue? Book a time to have a discussion with your boss. At the very least this could get the problem off your chest. Also, your boss may have great ideas for an easy resolution.

If your boss is ‘the problem’, have a discussion with your Human Resources (HR) department or Employee Assistance Program if you think counseling could help. They will protect your anonymity.

Step 6–elevate

If the problem is serious enough that it warrants further action, raise it again with HR. They might be able to organise an independent mediator.

You may need to raise a formal grievance or complaint in writing. If so, first head to the Fair Ombudsman’s website for ideas. It might be best to do this out of the office.

2. Ways to Find Community Group Connections

The trans community is hard to define, with widely varying tastes, social wants and needs, energy levels, accessibility needs, and more. So as much as it’s about finding some community, it’s also important to find the community that gathers in ways you find enjoyable and uplifting.

For some people, this will mean hanging out with other trans people of your gender, and for other people, it will be meeting people across the rainbow and making friends of all different genders and sexualities. You might find (or help set up) a trans board game club in Wagga, a soccer club for trans people in Dubbo, a trans author book club in Newcastle, or a trans-parents group that uses video to meet across the world. Whatever it is, wherever it is – the key is connection and community, so don’t give up.

Join Face-to-Face Events and Communities

Trans Pride Australia is a great place to start. They hold events throughout the year and also host a network of Facebook groups and other online spaces.

There are meetups, parties, and social events all over NSW. A great way to see what’s going on near you is to find a trans group for your city, town, or region on Facebook and see who’s posting about events. You could also join a broader trans-Facebook group like Trans Pride Australia and post to ask if there’s anything going on in your area. Sites like Meetup can be searched with keywords like ‘transgender’ to help you find groups near you, wherever you are.

If you’re in a regional area, check out ACON’s local guides or contact your closest ACON office to connect with the clubs and community groups nearby.

For advocates of the Hunter – the Hunter Gender Alliance (HGA) is a network of trans and gender diverse (TGD) people, health professionals, family members, and allies. The HGA works to make life better for TGD people in the Hunter and surrounding areas, including Newcastle.

Join Online Communities

We know that the outside world can be a tough place and online spaces offer a chance to safely connect with similar people, regardless of their location.

Trans communities congregate online across the globe, some are geographically focused while others are themed by areas of interest that enable discussions and support for things like a specific surgical or hormonal affirmation, pregnancy, breast, and chestfeeding, international advocacy, and topics related to art, housing, culture, and connection. Searching using keywords like ‘transgender’, plus the topic you’re interested in can be helpful.

It’s important to stay safe though so ACON and Trans Pride Australia worked together with Facebook, and Instagram to produce Safe and Strong: An LGBTQ+ Guide to Facebook and Instagram. The resource, released during the 2020 Sydney Mardi Gras season, features handy tips and practical measures on managing safety and exercising self-care while using Facebook and Instagram, including establishing your own online community group.

Start Your Own Groups

If you’re struggling to find a group near you that fits, or if a group can’t be found, one possibility is to start your own.

Creating a social group can take a bit of work, but is a great way to get in touch with your community, make friends, and give and receive support.

The first thing to consider is whom you might want to meet up with, whether it’s a specific interest, gender or sexuality group, or a broader community group. There’s no right or wrong answer to this question, other than what you think you and others will get out of it, and you can always change the guest list later.

The next thing is to think about where you could hold a social gathering. For small groups or people that you know, meeting in someone’s home is a good and cost-effective way of spending time together, but may not always feel comfortable when meeting with lots of new people. Instead, consider meeting at a cafe, bar, or another public place, especially if you know a place that’s LGBTQ+ friendly or owned. For some places, you can even call ahead and make a booking / let them know you’re holding a social group there.

After that, it’s a matter of getting the word out. This might involve posting it online, in groups, forums, and on social media, putting up physical posters in places you feel safe to do so, or just by word of mouth. Finding a friend or two to come along and support you is a great idea, both to help manage things if it’s a total hit, and to hang out with you if things start off slow. If that’s the case, that’s okay too! Sometimes these things can take time to build and take on their own energy, and as long as it’s not causing you to feel really uncomfortable or sad, that’s just fine!

3. Find mutual aid projects

Mutual aid is when people get together to help meet each other’s basic survival needs. It asks us to take responsibility for caring for one another and for working to change the conditions that impact people’s health and lives, not just through symbolic acts, or necessarily by political advocacy, but by building new social relations that improve quality of life. Mutual aid is a form of organising and caring in which groups take responsibility for providing mutual care and assistance (Nettle, 2015).

Engaging in mutual aid could look like online spaces providing Pay It Forward-style groceries or toiletries, community COVID-Relief groups, sex workers supporting each other through the pandemic, and even operations like Occupy Sandy, which provided disaster relief in Canada after Hurricane Sandy in 2012.

Mutual aid projects are usually volunteer systems or interpersonal networks of care, where participants are mutually passionate about changing conditions now, as opposed to waiting on systems and structures to make changes for the better.

An example: Your friend Hiro (he/they) has been suffering from some health issues and has been fatigued, unable to work, and is quite low on money. They also need to go to the doctor to fill their hormone prescription but have been procrastinating due to past transphobic experiences with medical professionals.

Here are some ways you could provide care to Hiro:

  • Accompany him to the doctors
  • Prepare some meals for them to put in the fridge to help them save money
  • Help them budget for the month
  • Help run errands
  • Research trans-friendly doctors for him

4. Build Resilience and Improve Self-worth with Trans Vitality Toolkit

Trans vitality toolkit:

Trans Vitality is ACON’s resilience-building program for all trans adults in NSW – binary and non-binary. Trans Vitality focuses on trans people supporting trans people, and centers on self-determination, autonomy, and agency, while uplifting trance voices (Transhub, 2022). It covers topics including understanding our roots, tools to connect and communicate, tools to grow and support ourselves, and how to prepare ourselves for good and bad times. A link to the Trans vitality toolkit: https://www.transhub.org.au/vitality

This Resilience Toolkit is one part of Trans Vitality and it includes information, activities, and resources to help build resilience, community connection, an understanding of our history, and a powerful imagining of our futures. Trans Vitality also includes some virtual peer workshops and online community training, an eLearning for mental health and crisis services, this Toolkit, and a full evaluation, gratefully funded by NSW Health (Transhub, 2022).

Remember, being trans isn’t about what you look like, the bathroom you use, or what your birth certificate says, being trans is about whom you know yourself to be, it’s about your gender being more wondrous and expansive than what was expected when you were born, regardless of whom others see (Transhub, 2022).

Connection to one another and to the communities we are a part of is central to our well-being, giving and receiving support even helps us build resilience and improve our self-worth.

Barriers services face when supporting individuals who are gender affirming

– Lack of staffing education on the needs of individuals transitioning genders or undertaking transgender hormone therapy.

– Lack of providers’ knowledge on topics of transgender health.

– Health system barriers (inappropriate electronic records, forms, lab references, clinic facilities)

– Widespread discrimination

– Lack of cultural competence

– Lack of training for staff and ​​health professionals in the provision of safe practice.

CASE STUDY:

Through our interviews, we identified that volunteers and employees who are transgender or non-binary believe that volunteering and work give them a sense of self-worth. They identified that having colleagues welcome them and make them belong to the work community encourages them to produce better work.

Advice for services when supporting an individual who is transitioning genders or undergoing transgender hormone therpay:

-Provide continuous training for all staff on the needs of individuals transitioning genders or undertaking transgender hormone therapy.

– Implement more inclusive electronic record, forms, lab references and clinic facilities – elaborate with examples of appropriate forms

– Not asking confirmation of gender from individuals when not necessary

– Use the preferred language someone transitioning genders prefers to be utilised

– If unsure of what pronouns to use, ask the individual what they would prefer

– Ensure inclusive access to bathroom facilities ( gender neutral bathrooms)

– Craft a transgender-inclusive nondiscrimination policy

– Be an ally for those who identify as transgender or transitioning genders

SERVICES & SUPPORT FOR THE TRANS & GENDER DIVERSE COMMUNITY

www.gendercentre.org.au

How to make a more inclusive environment

Trans people are protected against discrimination, harassment, and violence in many areas under NSW and federal law. Laws also protect your safety in public, and your privacy when interacting with large organisations or government departments. A way to make a work environment more inclusive is to alter the physical environment. A simple way to do this is to change old bathroom gender signs to more inclusive signs that symbolise the facility in the bathroom instead of the required gender to use the facility. This focuses less on the gender of the individuals using the facility and makes them more comfortable in the work environment by feeling included and accounted for.

Some examples of appropriate signs are:


Changing gender identity lists on forms

A simple way to provide a more inclusive work environment is to change the specifications of gender identify on forms. Workplaces should also avoiding asking for gender specification when not necessary.

It is important to allow for individual to have the option to write how they identity themsleves. This avoids assumption and ensures that they are able to provide the correct way they would like to be identified as.

EXAMPLE OF FORM OPTIONS:

What is your gender identity?

Female

-Male

-Non-binary

-Transgender

-Intersex

-Let me type

-Prefer not to say

How would you like to be refered as?

-She/her

-He/Him

-They/ Them

-Let me type

GENDER AND FORMS

www.reimaginegender.org

How to be an ally

Trans and gender-diverse people comprise an estimated 2% of the population. This means that, as cis people, you are in a great position to be strong allies for the trans people in your lives.

The difference between being someone who knows a trans person, and being our ally is the work put into affirming, supporting, and standing up for us (“Allies — TransHub”, 2022).

HOW TO BE A TRANS ALLY

www.minus18.org.au

How to model allyship

Ensuring HR systems adequately account for female, male and non-binary employees. Best practice indicators to use can be found in our Researchers page

Using their name and pronouns correctly and consistently, including in settings where they’re not present and even if others don’t

Correcting others when they use the wrong language or ask inappropriate questions

Adding pronouns as standard for all email signatures

Participating in specialist training, such as ACON’s Pride Training

Joining Pride In Diversity and Welcome Here

Stepping in when harassment or bullying occurs and demonstrating that transphobia is not welcome in your workplace.

(“Creating a Trans-Inclusive Workplace”, 2022)

We interviewed two individuals who identify as LGBTQIA + and believe there is a lot to learn from personal experience. All personal information and names have been changed to keep the privacy of our interviewees.

Interview 1:

Introduction of the interviewee:

Though my birth name is Kelly, my preferred name is Casper. I am a 27/28-year-old non-binary person on the Autistic Spectrum. Before I worked at my current workplace, I was a volunteer. I helped a service with online stuff. I am primarily responsible for Administration tasks.

Q. What motivates you to work/vol?

I am motivated, knowing that by helping a not-for-profit organisation, I am also helping the community. I strive to work towards a future where we can embrace diversity. Working and volunteering for a workplace that promotes equity and equality makes me feel like I am contributing to making that goal a reality.

Q. What do I like about work/vol?

I enjoyed volunteering because it gave me a sense of self-worth. I genuinely felt like I was making a difference and helping others made me feel extremely happy. Working has also greatly improved my mental health and social skills. I feel like I’m learning something new every day.

Q. What difficulties do you face with work/vol?

Self-worth is a significant challenge in the workplace. Establishing my gender identity as NB made me feel good about myself. It was like having painful weights lifted off me and breaking away shackles and chains that previously made me feel trapped. However, I constantly worry that people don’t see me as a person because I have separated myself from my standard male or female gender identity. I fear I’m annoying my co-workers by trying to remind them that I am they/them, and I worry about ruining my relationship with them. Because of this I don’t speak up about it anymore. This lowers my self-worth, makes me sad, and slows down my progress.

Q. What support do you need to do vol/work?

Patience, acceptance, understanding, and reassurance. I don’t expect everyone to get my pronouns right 100%- it makes me happy knowing that people try. Sometimes I may have slower days where I’m anxious or fearful of something- I may feel overwhelmed because I’m worried about whether the world sees me as a person or not- or If I’m worth anything to anyone. In those moments, having someone sit next to me and reassure me that I am welcome, seen, and accepted is enough to boost me back to happiness.

Interview 2:

Introduction of the interviewee:

Belle is a QA engineer at a bank. She struggles with anxiety and she is currently undergoing hormone therapy- She takes testosterone blockers and Estrogen tablets. This medication can make Belle hyper-emotional. This means she is prone to breakdowns at work.

Sometimes the medication can make her upset at things that other people might not see as big deal. Having a workplace environment that understands this, is important for Belle and other people undergoing hormone Therapy.

Q. What motivates you to work/vol?

Being a part of something greater than myself. And being a part of a project that can potentially do a lot of good for a lot of people.

Q. What do I like about work/vol?

The people I’ve volunteered with have been very friendly and fun to work with. Everybody knows I’m trans and nobody makes a big deal out of it.

The project I volunteered to be a part of also allowed me to make good use of one of my strongest skills.

Q. What difficulties do you face with work/vol?

A lot of anxiety. The project that I was a part of put a lot of emphasis on inclusivity, so we wanted people from all walks of life to participate. When new people joined the team, I would introduce myself to them as trans, which makes me very nervous because it’s impossible to guess how someone will react when you come out to them.

Q. What support do you need to do vol/work?

The best support is a safe space where being trans is not a problem for anyone. Plus working with colleagues who are okay with someone being trans, and will have your back when things get tough.

Also, being allowed to take breaks or step away from things temporarily due to anxiety.


Other relevant resources for services to be more inclusive

LGBTQ-Inclusive Practice Standards: (“LGBTIQ+ Inclusive Practice Guide – LGBTI Housing & Homelessness Projects”, 2022)

The Rainbow Tick Guide to LGBTI-inclusive practice (the Guide) aims to assist organisations to improve the quality of care and services they provide to their lesbian, gay, bisexual, trans, and gender diverse and intersex (LGBTI) consumers, staff, and volunteers. The Guide is built around six LGBTI-inclusive practice Standards. Each of the Standards is accompanied by its own set of quality-based indicators that organisations can use to gauge how well their current systems, practices, and protocols are meeting the intent of that particular Standard. The six LGBTI-inclusive practice Standards are:

▶ Organisational capability

▶ Workforce development

▶ Consumer participation

▶ A welcoming and accessible organisation

▶ Disclosure and documentation

▶ Culturally safe and acceptable services.

3 Keys to Creating a Transgender Inclusive Workplace: (“3 Keys To Creating A Transgender Inclusive Workplace – Agency Iceberg”, 2022)

The three keys to creating a transgender-inclusive workplace focus on implementing a gender identity policy, When an employee decides to transition, having an action plan in place, and offering practical help.

The 3 keys to creating a transgender-inclusive workplace understand workplaces that have a diverse and inclusive culture will be far more effective in dealing with the social impacts in their workplace of a transgender person working for them. Having policies and procedures in place helps to protect transgender people and enable them to feel more welcome in the workplace.

Other relevant resources for individuals

Resource Icon
  • TransHub

https://www.transhub.org.au

  • ACON

https://www.acon.org.au

https://hbr.org

  • Services and support for the transgender and gender diverse community

https://gendercentre.org.au


References

Bowen, F. & Blackmon, K. (2003). Spirals of Silence: The Dynamic Effects of Diversity on Organizational Voice. Journal of Management Studies, 40(6), 1393–1417. ​https://doi.org/10.1111/1467-6486.00385

Bretherton, I., Thrower, E., Zwickl, S., Wong, A., Chetcuti, D., Grossmann, M., Zajac, J. D., & Cheung, A. S. (2021). The health and well-being of transgender Australians: ​A national community survey. LGBT Health, 8(1), 42-49. https://doi.org/10.1089/lgbt.2020.0178

de Vries, K. M. & Sojka, C. J. (2022). Transitioning gender, transitioning race:

Blobaum, P. (2019). LGBTQ-Inclusive Hospice and Palliative Care: A Practical Guide to

Creating a Trans-Inclusive Workplace. Harvard Business Review. (2022). Retrieved 5 October 2022, from https://hbr.org/2020/03/creating-a-trans-inclusive-​workplace.

Cundill, P. (2020). Hormone therapy for trans and gender diverse patients in the general practice setting. Australian Journal Of General Practice, 49(7), 385-390. doi: ​10.31128/ajgp-01-20-5197

Dixon, J. & Dougherty, D. S. (2014). A Language Convergence/Meaning Divergence Analysis Exploring How LGBTQ and Single Employees Manage Traditional Family ​Expectations in the Workplace. Journal of Applied Communication Research, 42(1), 1–19. https://doi.org/10.1080/00909882.2013.847275

3 Keys To Creating A Transgender Inclusive Workplace – Agency Iceberg. Agency Iceberg. (2022). Retrieved 5 October 2022, from https://agencyiceberg.com.au/3-​keys-creating-transgender-inclusive-workplace/.

Safer, J. D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J. (2016). Barriers to healthcare for transgender individuals. Current opinion in ​endocrinology, diabetes, and obesity, 23(2), 168–171. https://doi.org/10.1097/MED.0000000000000227

Seelman, K. L. (2016). Transgender Adults’ Access to College Bathrooms and Housing and the Relationship to Suicidality. Journal of Homosexuality, 63(10), 1378–1399. ​https://doi.org/10.1080/00918369.2016.1157998

Stefani, L. & Blessinger, P. (2017). Inclusive Leadership in Higher Education : International Perspectives and Approaches. (1st ed.). Taylor and Francis.

Stute, P. (2014). Is transdermal menopausal hormone therapy (MHT) associated with an increased cardiovascular risk? Archives of Gynecology and Obstetrics, ​290(4), 617–619. https://doi.org/10.1007/s00404-014-3372-8

Transforming Professional Practice. Journal Of The Medical Library Association, 107(4). https://doi.org/10.5195/jmla.2019.766

Transgender people and multiracial positionality. International Journal of Transgender Health, 23(1-2), 97–11. https://doi.org/10.1080/26895269.2020.1838388

Williams, C. L. & Dellinger, K. (2010). Gender and sexuality in the workplace. Emerald.

Nettle, D. (2015). Mutual aid. Open Book Publishers.

Nota, N. M., Wiepjes, C. M., de Blok, C. J. M., Gooren, L. J. G., Kreukels, B. P. C., & den Heijer, M. (2019). Occurrence of Acute Cardiovascular Events in Transgender ​Individuals Receiving Hormone Therapy: Results from a Large Cohort Study. Circulation (New York, N.Y.), 139(11), 1461–1462. ​https://doi.org/10.1161/CIRCULATIONAHA.118.038584