Mental Health Providers’ Biases, Knowledge, and Treatment Decision Making With Gender-Minority Clients

Despite the growing literature on barriers to mental health care experienced by gender-minority individuals, there are few studies that describe mental health providers’ competencies for delivering care to transgender clients of mental health care. The current study was designed to explore the relationships between mental health care providers’ (N = 107) transphobia, gender minority-specific knowledge, and hypothetical treatment decisions when working with gender-minority clients. Online surveys gauged providers’ transphobia using the Genderism and Transphobia Scale (Hill & Willoughby, 2005) as well as their knowledge based on self-reported understanding of gender minority–related issues. Treatment decisions were based on three sets of vignettes that measured providers’ responses to both transgender and not explicitly transgender clients in comparable situations. Transphobia negatively predicted knowledge, such that higher transphobia scores were correlated with lower knowledge scores, F(1, 85 = 24.16), p =.02, R2 =.22. Similarly, transphobia was significantly predictive of treatment decisions in the sample, F(1, 76) = 33.66, p <.01, R2 =.31, wherein higher transphobia scores were associated with a wider discrepancy in treatment decisions between transgender and not explicitly transgender clients. The significant relationships between these variables warrants a call for targeted bias-reduction efforts among mental health providers to improve services for and reduce discrimination against gender-minority individuals accessing mental health services.