JEA Q3 2019

Best Practice Guidelines for Transgender Employees

Carolyn Ruck, LCSW

How should employee assistance professionals respond when an employee requests workplace support while fulfilling the final steps of a gender transition process? In the past decade many organizations have gained a greater understanding of how diversity impacts workplace culture and the financial bottom line. Yet, when employers call for guidance with transgender workplace issues, apprehension remains.

When facing gender transition in the workplace, the EAP offers a great resource because employers recognize a critical need for information and collaboration. Most often, it is the lack of clarity that proves problematic for the transitioning employee, and risky for organizational well-being at all levels.
Lack of awareness, vague policies, and the absence of diversity programs and management training can be stressful and costly for an employer. An employee’s gender change disclosure, if not handled well, can lead to any combination of complaints, interpersonal conflicts, rumors, or claims of a hostile work environment, harassment or discrimination.

Conversely, EAP guidance can enlighten and ease the organizational adjustment process. An experienced consultant can offer understanding and information about the unique personal issues faced by the transitioning employee. EA professionals can coordinate discussions and educational options for top leaders, managers, and staff as well as offer human resource guidance about organizational issues that will likely arise when Jim transitions into Joanne, or vice versa.

In the Diagnostic and Statistical Manual (DSM) used by mental health professionals to diagnose psychological conditions, the diagnostic label gender identity disorder (GID) was used by the DSM until its reclassification as gender dysphoria in 2013, with the release of the DSM-5. The diagnosis was reclassified to better align it with medical understanding of the condition and to remove the stigma associated with the term disorder (Fraser et al, 2010; Bryant, 2018).

The American Psychological Association (APA) permits a diagnosis of gender dysphoria if the criteria in the DSM-5 are met. The DSM-5 states that at least two of the following criteria for gender dysphoria must be experienced for at least six months in adolescents or adults for diagnosis (American Psychiatric Association, 2013):

* A strong desire to be of a gender other than one’s assigned gender;
* A strong desire to be treated as a gender other than one's assigned gender;
* A significant incongruence between one’s experienced or expressed gender and one’s sexual characteristics; 
* A strong desire for the sexual characteristics of a gender other than one’s assigned gender;
* A strong desire to be rid of one’s sexual characteristics due to incongruence with one’s experienced or expressed gender; and
* A strong conviction that one has the typical reactions and feelings of a gender other than one’s assigned gender.

In addition, the condition must be associated with clinically significant distress or impairment (APA, 2013).

A Process That Requires Organizational Attention and Planning
Historically, many transgender persons would change jobs rather than staying on a job facing discrimination, harassment or termination due to being non-gender conforming.

However, recent trends suggest that individuals who identify as transgender are increasingly willing to risk “coming out” at work. When a transgender person, usually after years of internal angst, decides to undergo complete gender transition, the results are impossible to conceal at work.
Consider how this level of disclosure compares with other employees who choose when and how to reveal personal information at work, including sexual orientation. Transgender persons who plan to remain with their employer while transitioning don’t have that option. A transgender employee is obligated to “come out” to his/her employer in order to comply with treatment requirements to live full-time in his/her new gender role for at least one year before irreversible surgery.

Employers become involved in the gender transition out of necessity. Many workplaces have been emerging from an unspoken “don’t ask don’t tell” culture towards inclusiveness and respect for differences. Misinformation and misperception about transgender persons can cloud effective organizational responses.

Facts to be Aware Of 
The facts in the following section are based on my clinical and consulting experience and the Human Rights Campaign.

FACT: Transgender persons experience a significant amount of discrimination because of their gender identity or expression. Some are also targets of homophobia and hate crimes whether they are same-sex oriented or not. 

FACT: Transgender persons who announce their transition at work will generally not be out of work right away if they decide on genital reconstructive surgery. This often comes at a later time when they will be asking to be identified as the new gender and new name, use gender appropriate restroom, etc. when they first come to HR. 

FACT: A gender transition is a long process with workplace disclosures generally occurring at later stages. 

FACT: Gender identification is NOT the same thing as sexual orientation. Just like anyone else, transgender persons can be heterosexual, homosexual, bisexual or asexual. Gender identity is who a person is. It is not descriptive of the individual’s sex life.

FACT: When a male-to-female transgender person presents as a woman, she should be regarded as a woman, just as a female-to-male transgender person should be regarded as a man.

FACT: Genital surgery is one way to align physically on the outside with what has always been felt/experienced on the inside. The process may include psychotherapy, living as the other gender, taking hormones, re-socialization, and other adjustments. Although there are transgender persons who have surgery and do not take hormones, and vice versa.

FACT: Gender and sexuality exist on a spectrum of physiological and psychological characteristics. Research indicates that throughout history there have been people whose internal gender identity was different from their birth gender.

Best Practice Guidelines
The following are best practice guidelines regarding transgender issues in the workplace. While specifically designed for managers and human resource representatives – they are also recommendations that EA professionals should be aware of.

* When meeting with the transitioning employee, keep an open mind and acknowledge your own level of experience. Ask questions and express a willingness to learn, adapt, and support. 

* Review current company polices for addressing harassment and discrimination. Should employee relationship issues arise, these documents will help guide your responses.

* Include corporate legal counsel throughout the transition process. You’ll need to know which state, county or city laws may apply to employment actions involving the employee. Remember that a transitioning employee needs to provide consent prior to the organization disclosing even limited personal health information.

* Obtain time frames from the transitioning employee in order to determine company timelines for responding to changes (e.g., Jim plans to return as Joanne after medical leave of absence in early October). Most employers coordinate leader and staff trainings prior to the employee’s return to work.

* Strive for endorsement of company anti-harassment and respect policies from the top down. Once the tone of acceptance and respect for diversity is established and conveyed by key leaders, front line supervisors are usually motivated to put policies into everyday practice.

Unfortunately, even if an organization has specific policies covering protected classes; some claims of harassment and discrimination may bubble up from the front lines. This is why transgender-at-work training for managers and staff can be beneficial.

* Include the transitioning employee in most aspects of organizational planning and response. After all, you’ll be involved in some very personal disclosures. Assure the employee of your support.

* Plan to follow up privately and periodically to see how the transitioning employee is doing. This is especially important during the first three months after his or her new gender appearance becomes apparent at work.

* Avoid focusing on genital surgery vs. the entirety of the transition process at work. Not all transgender individuals have genital or breast reconstructive surgery. Some may have hormone therapy, vocal retraining, and cosmetic or facial treatments.
When I first started consulting with organizations, many HR reps seemed fixated on evidence of genital surgery as the marker for when the employee should use new gender-identified bathrooms. 

* The date the employee presents, as his/her target gender is the day to begin using the restroom that reflects his/her new gender. The employee should not be forced to use the restroom that matches his/her previous gender.

* It may be necessary to review your organization’s non-discrimination and anti-harassment policies. For example, if the company receives staff complaints about being uncomfortable working with the transgender employee or there are concerns regarding joint bathroom use. Consider suggesting an EAP referral to help that individual adjust to workplace realities.

* Remind staff that their transgender co-worker is still essentially the same person. Encourage the same levels of work and social interactions.

* Recommend education for organizational leaders first – before any training for line staff. Be aware that managers with little exposure to transgender issues may need more time to digest the information.

* Determine which customers or vendors need to be updated about the change in gender. This includes “when” and “how.” 

* Plan for administrative and benefit updates to ensure they are completed by the day the transsexual employee begins appearing at work as their target gender. This includes health insurance and other benefit changes, photo ID, name in company directory, etc.

Looking Ahead
Employers that proactively develop and implement workplace strategies that address harassment and discrimination against all employees have an opportunity to enhance corporate reputation, and increase job satisfaction and employee morale. Results may include greater productivity, less staff turnover, and fewer risks of litigation.

Discrimination cases are costly in terms of time, legal fees, and goodwill. Companies with established diversity programs and management systems to address and resolve charges of discrimination and harassment may be at less risk for employment lawsuits.

With increasing media attention to LGBTQ individuals and roles, societal exposure to diversity is increasing. This fact, combined with increasing employment protections, means an EA professional is likely to see transgender issues arising in the workplace over the course of a career.
The best and brightest young employees will be considering employers based on several factors, including progressive workplace policies. If a company is going to attract these employees, it makes sense to advocate for employment policies that are inclusive of gender identity.

EA professionals are able to highlight the importance of organizational inclusiveness, make the business case for it, and find ways to untangle organizational webs of fear and uncertainty. They are a valuable resource in this regard, so take advantage of it.

Carolyn Ruck is an out-patient psychotherapist specializing in LGBTQ issues and previously provided corporate consulting and training for dozens of employers, providers, and colleagues in her role as Consultation Manager at Empathia Inc., EAP. She may be reached at


American Psychiatry Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th ed.). Washington, DC and London: American Psychiatric Publishing. pp. 451-460.

Bryant, K (2018). Gender Dysphoria. Encyclopedia Britannica Online. Retrieved from

Fraser, L; Karasic, D; Meyer, W; Wylie, K (2010). Recommendations for revision of the DSM diagnosis of Gender Identity Disorder in adults. International Journal of Transgenderism. 12(2): 80–85.

Laura’s Management Consultation Regarding a Transgendered Employee

The following consulting case lasted approximately three months from the first call to the final follow-up.

EAP Consultation Sought
Laura, an HR director at a manufacturing plant called the EAP for a phone consultation. Bill, a product engineer, had just disclosed to Laura that he has been transitioning from male to female and would like her help in announcing his gender change and new name at work. Bill would now be known as Bonnie. 
Bill told Laura that he has been dressing and appearing as female outside of work.  He added that he and his providers agree that he is ready to start living full-time as Bonnie.

Laura told the EAP consultant she reassured Bill of the company’s support and that she would do all she could to pave the way for Bonnie to be welcomed as herself in a safe environment.  Privately, she saw obstacles and was personally overwhelmed with the reality of having known Bill and his wife for years. She had no idea that Bill was carrying around “this secret.”   

HR Concerns
Laura considered herself a seasoned HR professional, yet she had never handled a transgender disclosure in the workplace. She worried about managing harassing behaviors from Bill’s colleagues. She was concerned that certain female staff would be uncomfortable if Bill used the female restrooms. She also knew that several female staff were religious and would use faith as a basis to stir up trouble, even-bad mouthing management if Bill was allowed from their perspective to “wear drag”.

Laura was well aware that Fred, the CEO of the company, could be a bit old school and since she remembered he had made homophobic remarks in public, she could only imagine how he would respond when he learned that Bill was transitioning.

Learning More about Transgender Issues from the EAP
Laura called the EAP to understand more about transgender issues, to establish an internal plan and timeline for supporting the transition process, and review how current company policies on harassment and discrimination could be the foundation for establishing expected workplace behaviors for the top leaders all the way to front line staff.

Laura also needed safe, reassuring guidance to sort out her own feelings about Bonnie. We set up a series of phone consultations through which Laura began to recognize the leverage of her position and her ability to influence and shape the company’s response to welcoming Bonnie. 
The EA professional suggested that Laura plan a series of follow-up meetings with Bonnie to obtain more information and with Bonnie’s consent, to specify what to disclose, when to disclose and to whom.  

She recommended that Laura review her current company policies on non-discrimination and harassment before meeting with the CEO, then lay out her hope for how Fred the CEO would set the tone.

Transgender Training & Flyers
She suggested that after Bonnie provided specific consent for disclosure, that managers and then staff members receive transgender at work training through the EAP. She personally screened a local EAP trainer with this type of expertise. She also created EAP informational flyers for co-workers and for managers. 
I helped develop the flyers and the trainings during my employment at Empathia Inc. EAP so this info would be proprietary. There were manager and E-versions of each. 

The training materials highlighted factual information vs. myths about the transgender change process. It relayed general information about medical treatments and length of time before full transition may be achieved.
The training materials also provided guidance for co-workers about helpful responses to a transitioning individual, including making a concerted effort to use correct gender pronouns and name. The flyers were brief and offered the EAP 800 phone number if staff needed to talk privately with an EAP professional.

Next Steps; Reviewing Policies
Over the next few weeks, Bonnie disclosed her transgender status to a select group of engineering co-workers ahead of the company announcement. Bonnie felt they handled it better than she expected. Some co-workers needed time to digest the news and came to her later with questions, which she was comfortable answering. Other colleagues didn’t seem phased by the news.  

Once a general announcement from the CEO was made as to Bill’s gender identity and name, two female staff members came to HR about Bonnie using the women’s restroom. Since there were non-gender specific restroom options and Bonnie felt comfortable using a unisex bathroom, the initial bathroom complaint never came to fruition.

Transitioning employees should use the restroom that matches his/her target gender. The workplace should not put the burden on the transitioning employee to use a restroom that no longer fits and there is legal precedent to affirm this position. If the employee feels more comfortable using the unisex bathroom (as was in this case) there was no reason for staff to complain.
However, it was important that Laura explained to the female staff members that under company policy, Bonnie IS female and should be treated with the gender respect afforded to all staff.  Laura and I reviewed differences between gender and sexual identity. We thought that the concerned female staff were likely making false assumptions. 

I explained that Bonnie, having gone through a long process of medical treatments, would NOT be wanting to use the women’s restroom for inappropriate behavior. I sometimes use metaphors to illustrate. If lesbian staff are attracted to females should they be forced to use the men’s restroom? If gay staff are sexually attracted to men, should they be using the women’s restroom, and my favorite, how does anyone really know what sort of sexual equipment anyone else possesses when they are in a restroom stall?

Ultimately, Bonnie and Laura agreed upon a plan that consisted of a target date for the CEO’s announcement to take place, followed by mandatory EAP trainings on transgender issues for applicable managers and staff. Bill then presented as Bonnie after taking two days off of work during the EAP trainings.
I kept in touch with Laura before and after Bonnie transitioned and encouraged her to check in with Bonnie every few weeks. In those check ins, I recommended that Laura sift out whether there were signs of workplace bullying or conduct toward Bonnie that needed HR intervention.
Fortunately there were not. I believe that the on-site training that the EAP provided in addition to the CEO announcement went a long way toward ensuring a peaceful transition for all involved.
- Carolyn Ruck