Beyond Gatekeeping: Using the WPATH Standards of Care



ONLINE COURSE | Instructor: Hunter Swanson, M.S.W., LICSW
CEs: 1.5 | Level: Intermediate

Date of original webinar: October 28, 2020, noon - 1:30 p.m. ET

This webinar aims to provide a review of some of the tools available to us as clinicians that inform the documentation specific to collateral work on behalf of trans & nb clients. We will review ways in which gatekeeping has been a historically problematic element of clinical care and explore resulting challenges that may arise around trust and rapport-building in the therapy relationship, then shift to a more radical frame of using gatekeeping tools effectively to advocate for clients with surgeons, insurance companies, and other entities that may be in a position to provide or deny care.

We will focus particular attention on supporting clients with non-binary identities in accessing medical interventions and identifying places in which therapists can serve in an advocacy role while empowering clients to engage confidently with providers in order to get their needs met.

We will review elements of letter-writing and the components of strong documentation, with some in-depth discussion of concerns that often arise for therapists doing this work (complex cases, concerns about liability/client regret, ambivalence about holding a decision-making role).

We will also unpack ways to engage in transparent conversation with clients about assessment processes and the power dynamics inherent to those processes, and discuss use of self, role of self-disclosure, and the importance of holding awareness of identity dynamics in the room with an eye toward intersectionality.

Target Audience: 

Social workers and other social service providers.

Course Delivery Method and Format:

Recorded webinar, self study. All courses are hosted on SmithOnline. Login information will be emailed immediately after registration to the email address entered during registration.

System Requirements:

Attendees will need access to a computer with internet and the capability to play recorded videos.

Registration Fee and Deadline:

CEs: 1.5 CEs are available for social workers and psychologists for a $5 fee. 

Learning Objectives:

  1. Describe how the Standards of Care is a tool and as a document to support client needs.
  2. ​Explain how to create documentation to facilitate trans/nb clients' access to necessary services, and will have a clear understanding of which services their clients may be likely to need.
  3. Identify their own implicit biases located in aspects of identity/experience.
  4. Describe how to effectively manage implicit bias to navigate gatekeeping aspects of therapist role and to stay in growthful, authentic relationship with clients.


  1. Introduction of presenter, of topic and course objectives
  2. Introduction of WPATH Standards of Care, history of the SOC & background context. 
  3. Brief history of trajectory of gatekeeping relationships in therapy over the past several decades.
  4. Discussion of current needs around documentation for trans/nb clients as the gatekeeping role has evolved, with specific examples given.
  5. Discussion of concerns that may arise for clinicians in a position of providing documentation (liability concerns, complex cases, structural barriers such as clinic policy)
  6. In-depth look at the SOC with focus on language that can be used intentionally to support clients' requests for transition-related medical intervention, with additional attention given specifically to the needs of non-binary clients. 
  7. Review of language that can alleviate some of the clinician concerns noted above and provide a framework within which clinicians can feel freed up to engage in authentic relational work.
  8. Discussion of barriers to competent care, including clinician bias and issues of systemic racism/oppression, with strategies for interrupting these barriers.
  9. Discussion / Q&A


Instructor Biography:

Hunter Swanson, LICSW is a therapist who has been working in the field for the past decade, with a primary focus on providing care for the queer community. He was clinically trained at the Smith School for Social Work. His practice utilizes narrative and relational approaches to support clients in increasing their sense of efficacy and authenticity, and works to interrupt systemic harms inflicted by legitimized systems of power.

Completion Requirements for Recorded webinars and online courses.

To receive a CE certificate, you must complete the entirety of the recorded webinar or recorded video presentation. Partial credit will not be awarded to those who attend only a portion of the class. For recorded webinars and online courses, participants must complete an evaluation and a post test, noting the length of time to complete the course. Participants must earn a minimum score of 80 percent on the post test in order to earn CEs. Retesting is allowed up to five (5) times. If a passing score is not achieved, CEs will not be awarded. Links to the evaluation and post test are available in SmithOnline. Participants must also complete an attestation of completion for each fully completed course. A copy of the attestation is available in SmithOnline. It is attendee’s responsibility to contact their state licensing board/certification boards to determine eligibility to meet continuing education requirements.

How Will a CE Certificate Be Awarded?

Upon completing the course evaluation and successfully passing the post test, participants will be emailed their online certificate​ within 30 days of course completion​. ​Participants should save and/or print ​the certificate upon receipt for ​their records. Receiving the CE certificate is contingent on submitting attestion, completion of the evaluation and passing the post test.

Continuing Education Credits and Accreditation

Social Work CE Credit: The Smith College School for Social Work, provider #1755, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. The Smith College School for Social Work maintains responsibility for this course. ACE provider approval period: 11/19/2020-11/19-2021. Social workers completing this course receive 1.5 continuing education credits. 

The Smith College School for Social Work is accredited by the Council on Social Work Education and is therefore authorized to provide CEs as a postsecondary institution accredited by CSWE in many states. Courses offered through the School's Program of Professional Education are awarded continuing education credits in accordance with Continuing Education Regulation 258, CMR, 31.00 in the Commonwealth of Massachusetts. Smith College School for Social Work, Office of Professional Education SW OPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0169. If outside these states, please contact your licensing board for accreditation information regarding your state. Association of Social Work Boards database of social work licensure requirements.

Psychology CE Credit: Co-sponsored training events for psychology CE credit with Smith College School for Social Work. Amego Prepare​ is approved by the American Psychological Association to sponsor continuing education for psychologists. Amego Prepare maintains responsibility for this program and its content. Due to changes in continuing education requirements for NY licensed psychologists, APA CE Sponsor credits may not be accepted for re-licensure at this time. Please check the NY Psychology Board regulations for CE requirements currently in effect.