Provider Violence (Non-Medical)

Trans Specific Dynamics

One of the overarching themes FORGE heard in listening sessions with trans and nonbinary survivors was that abuse by authority figures often caused more harm than other forms of violence. When seeking care from a provider, especially after experiencing a crime, trans and nonbinary people have to be vulnerable and put their trust in someone they don’t know to help them. When this trust is broken, it can prevent someone from seeking help in the future.

“The assaults perpetuated by authority figures and those in positions of power over me have left the longest-lasting damage.”[i]

Conversion therapy

Conversion therapy involves harmful attempts to “change someone’s sexual orientation, gender identity, or gender expression” to fit with dominant cultural norms[ii]. While conversion therapy is widely recognized as ineffective and abusive, it is still legal in 19 states for minors, and all states for adults[iii]. Even in states where conversion therapy is banned for minors, “these laws apply only to licensed therapists, and not to clergy or unlicensed counselors (like life coaches), leaving open the possibility that minors in these states could still be subjected to forms of conversion therapy.”[iv]

Therapists and other service providers may use conversion therapy to attempt to change someone’s sexual orientation or gender identity. As noted in the section on medical abuse [link], this is not just limited to mental health care providers:

“The doctor figured out I was trans and practiced conversion therapy without telling anyone, including my parents. I tried to tell my family that the doctor was not working, but nobody listened. I was sent there for over three years. I became so badly suicidal that I didn’t go a minute without thinking of death.[v]”

Conversion therapy contributes to heightened levels of psychological distress and suicidality , creating additional challenges and distrust for trans and nonbinary people[vi].

Non-consensual contact with law enforcement

In addition to conversion therapy, some trans and nonbinary people are subjected to coercive “treatments” that end up causing further harm. Someone who expresses thinking about suicide might be forcibly hospitalized and mistreated by staff or other patients. A Black or Brown trans person who has the police called on them to do a “wellness check” is put at further risk of abuse by law enforcement, along with potentially being criminalized for their various identities. People of color, trans people, and folks with disabilities and/or mental health concerns experience higher rates of violence from law enforcement, even when they are being called to help the person. Folks with overlapping identities are even more likely to experience harm.

For more information on responding to suicide and crisis with marginalized clients, check out this webinar: “Liberatory Responses to Suicide and Crisis.”

Read more about the role of mental health providers as mandated reporters and how to reduce harm in this section [link to mental health providers section]

Sexual assault

Sexual assault can occur in any relationship with a service provider. Providers may use a person’s trans identity to leverage power over them, especially when they are gatekeeping access to resources (e.g., a shelter, a letter required to access gender-affirming care, financial support, etc.).

On a past FORGE survey, one participant shared an experience of being sexually abused by a therapist:

“I was inappropriately used sexually by my gender therapist in [city withheld]. He began sexually advancing to show me how to be a “real man,” as a way of modeling masculine behavior. It became obvious that I needed to be sexual with him in order to receive the required letter to have chest surgery. We had sex a countless number of times—sometimes in his office, sometimes my house, sometimes he would make me take him out to dinner and pay the bill. When I realized that this was wrong, I asked him for my surgery letter so I could discontinue “therapy.” He refused and I had to pay thousands of dollars to reestablish a relationship with another therapist in order to get a surgery letter.”[vii]

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