Sex, sexuality, sexual preference, gender, gender identity, gender expression, and gender norms are often confused in our discourse. It is essential for counselors to understand and become comfortable with these terms, if we are going to support the gender health of all our clients.
Some clients will experience gender dysphoria (DSM-5) or gender incongruence (WHO/ICD-11). Gender dysphoria is the “discomfort or distress related to incongruence between a person’s gender identity, sex assigned at birth, gender identity, and/or primary and secondary sex characteristics” (APA).
According to the Standards of Care published by the World Professional Association for Transgender Health (WPATH), “The general goal of psychotherapy is to find ways to maximize a person’s overall psychological well-being, quality of life, and self-fulfillment. Psychotherapy is not intended to alter a person’s gender identity; rather, psychotherapy can help an individual to explore gender concerns and find ways to alleviate gender dysphoria, if present” (p. 28).
Since 1992, I’ve accompanied transgender, gender diverse & intersex persons ages 8-70+, first as a pastor and then as a mental health counselor. In 2019 I became one of the first 87 providers in the world to earn the international specialty credential in transgender health through WPATH. In 2018, I gave the first lecture in transgender health at USD’s medical school. I collaborate with physicians, surgeons, and health system leaders, both locally and nationally, and with businesses and education systems on behalf of clients. I work closely with Mayo Clinic, and with 8 other medical teams across the United States.

This presentation will provide an introduction to gender health and the basics of counseling transgender, gender diverse & intersex persons. 

After earning a PhD in clinical psychology, Anne completed a post-doctoral residency in Fargo with an emphasis on assessment and treatment of ADHD, high functioning Autism (hfASD), and related conditions. A particular area of interest is working with women and girls, because research begun in 2012 shows that — due to the effects of estrogen -- the symptoms of these conditions appear quite differently in females, and so they are often misdiagnosed and misunderstood.
In addition, Anne specialized education, training, and experience in transgender/gender diverse (TGD) healthcare. She has been accompanying persons in exploring their gender identity and sexuality since 1992. She completed the requirements for the international gender health specialty certification through WPATH (World Professional Association for Transgender Health). In 2019, Anne became one of the first 87 healthcare providers in the world (and the first in South Dakota) to become a WPATH Certified Gender Specialist.
That training has included sessions at the University of Minnesota Medical School, The Ohio State University College of Medicine, the Icahn School of Medicine at Mt. Sinai Hospital in New York City, and Harvard Medical School, as well as training through the U.S. Department of Justice. Anne regularly collaborate with primary care, endocrinology, and surgical teams in Sioux Falls and across the U.S., including the University of Minnesota, and the Mayo Clinic in Rochester, MN. I also work with medical teams in Chicago, Philadelphia, Scottsdale, Madison (WI), and the San Francisco Bay Area. She also provides education in transgender/gender diverse (TGD) healthcare for the Sanford School of Medicine at USD, regional healthcare systems, healthcare professionals, universities, businesses, and professional organizations. 
Anne's 4 children and their families serve our country in locations across the world. Closer to home, Anne and her dogs are part of Therapy Dogs International, and they volunteer as Tail Waggin’ Tutors on Saturdays at the Sioux Falls Downtown Library. She is also one of the Keepers of the Canton Native Asylum Story, and has been involved in the Keeper's restorative justice process with 53 Native Nations since 2012.

World-wide, studies from 2012 to 2020 show that Autism Spectrum Disorders look different in girls and women. This seems to be due to the effect of estrogen on the developing brain. As a result, researcher Kevin Pelphrey says, “Everything we thought was true of autism seems only to be true for boys.” 
Many girls and women with ASDs are lost in the mix because they are trying to be someone else. Depressed and anxious, they suffer in silence for years. Others, because of their unique sensitivities and their responses to confusion and overwhelm, are misdiagnosed as having Gender Dysphoria, Borderline Personality Disorder, Obsessive-Compulsive Disorder, and more. These life-long labels lead to well-intentioned interventions that often make things worse. Many are prescribed medications they may not need. No wonder they come to us confused and hurting, with no way to explain what is wrong.
We are learning that the key to diagnosing girls and women is to listen carefully to what they are telling us; to listen “between the lines.” Between the lines, they are telling us how they camouflage their inner lives and how they are desperately attempting to fit in and appear “normal.” 
Using PowerPoint and stories and new research methods with girls and women, this presentation will normalize symptoms, explain neurological differences, offer strategies for listening and looking deeper, and provide resources for supporting girls and women with ASDs in being more fully and uniquely themselves.

After earning a PhD in clinical psychology, Anne completed a post-doctoral residency in Fargo with an emphasis on assessment and treatment of ADHD, high functioning Autism (hfASD), and related conditions. A particular area of interest is working with women and girls, because research begun in 2012 shows that — due to the effects of estrogen -- the symptoms of these conditions appear quite differently in females, and so they are often misdiagnosed and misunderstood.
In addition, Anne specialized education, training, and experience in transgender/gender diverse (TGD) healthcare. She has been accompanying persons in exploring their gender identity and sexuality since 1992. She completed the requirements for the international gender health specialty certification through WPATH (World Professional Association for Transgender Health). In 2019, Anne became one of the first 87 healthcare providers in the world (and the first in South Dakota) to become a WPATH Certified Gender Specialist.
That training has included sessions at the University of Minnesota Medical School, The Ohio State University College of Medicine, the Icahn School of Medicine at Mt. Sinai Hospital in New York City, and Harvard Medical School, as well as training through the U.S. Department of Justice. Anne regularly collaborate with primary care, endocrinology, and surgical teams in Sioux Falls and across the U.S., including the University of Minnesota, and the Mayo Clinic in Rochester, MN. I also work with medical teams in Chicago, Philadelphia, Scottsdale, Madison (WI), and the San Francisco Bay Area. She also provides education in transgender/gender diverse (TGD) healthcare for the Sanford School of Medicine at USD, regional healthcare systems, healthcare professionals, universities, businesses, and professional organizations. 
Anne's 4 children and their families serve our country in locations across the world. Closer to home, Anne and her dogs are part of Therapy Dogs International, and they volunteer as Tail Waggin’ Tutors on Saturdays at the Sioux Falls Downtown Library. She is also one of the Keepers of the Canton Native Asylum Story, and has been involved in the Keeper's restorative justice process with 53 Native Nations since 2012.