Psychologist and trans-health educator Sand Chang joins us to talk about the complex experience of body acceptance for trans folks, the intersections of trans advocacy and Health at Every Size work, the growing body of research around trans folks and eating disorders, the shape-shifting nature of fatphobia and diet culture, and so much more!

Dr. Sand Chang (they/them) is a Chinese American, gender fluid and non-binary trauma informed psychologist. In today's conversation, Josie and Dr. Sand discuss the importance of body liberation specifically for trans health, and how diet culture can impact those who are trying to conceive.

Chang, S. C. (2022). EMDR Therapy as Affirmative Care for Transgender and Nonbinary Clients. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy: Innovative strategies and protocols, 2nd Ed.. New York: Springer Publishing Company.

This book is geared towards mental health providers who are working with trans and/or nonbinary clients.

Chang, S. C., Singh, A. A., & dickey, l. m. (2018). A clinician’s guide to gender-affirming care: Working with transgender and gender nonconforming clients. Oakland, CA: New Harbinger.

The present study addresses many of the methodological issues encountered during the Trans Bodies, Trans Selves Survey (2nd Ed.). By reflecting on how these issues relate to previous research, we provide recommendations on how to produce more representative data while remaining accountable to trans and nonbinary communities.

According to Sand Chang, a clinical psychologist who works with trans individuals and identifies as nonbinary, transgender men face comparisons to both cisgender men and other transgender men. Therefore, trans men have two ideal body types against which they can gauge their own idea of a successful transition.

It can be hard, at times impossible, to separate out the different pressures we face living day to day in our trans and non-binary bodies. When it comes to existing in relative comfort, it’s not just about aesthetics. It’s about safety, access, all the things we are not talking about. And we need to talk about eating disorders in the trans community because they are killing us.

I want to shift the conversation to talk about how mental health providers can be helpful in supporting trans patients through the process of seeking and receiving gender-affirming medical care. As a health care system, we need to move away from gatekeeping based on gender narratives and toward a more client-centered, collaborative approach that focuses on informed consent.

We who identify as nonbinary spend so much time saying who we are not that we never get time to focus on ourselves, to celebrate and honor who we are. Nonbinary is only in relation to the colonizer, to White culture, to Western, mutually exclusive ideals of masculine and feminine. It still centers their experiences as normal, typical, the true measure of gender.

I envision a future, maybe not one that I will ever witness myself, in which bodily autonomy and body liberation exist for all people…What is the world you envision and want to fight for?

I continually question my own motives and rationalizations. I’ve told myself that it is a reality that there are gates, and someone has to be there to open them. But why not work to destroy these gates?

Chang, S. C., & Singh, A. A. (2016). Affirming psychological practice with transgender and gender nonconforming people of color. Psychology of Sexual Orientation and Gender Diversity, 3(2), 140–147. https://doi.org/10.1037/sgd0000153

In this article, the authors discuss the unique considerations that psychologists may keep in mind when working with transgender and gender nonconforming (TGNC) clients of color.

In this handbook of trans-affirming counseling, I co-authored four chapters on these topics:

Gender and Sexual Orientation Diversity within the TGNC Community.

Affirmative Counseling with Trans/Gender-variant People of Color.

Working With TGNC Primary Caregivers and Family Concerns Across the Lifespan.

Advocacy and Social Justice: The Next Generation of Counseling and Psychological Practice With Transgender and Gender-Nonconforming Clients.

Despite the growing visibility and acceptance of transgender and gender nonconforming (TGNC) individuals, TGNC older adults experience many barriers in accessing competent and affirming health and social services due to anti-TGNC prejudice, discrimination, and lack of competent healthcare training on the part of healthcare workers. Clinical gerontologists and geriatricians will likely encounter TGNC adults in their practice given population aging and greater numbers of TGNC people who are living in their affirmed gender identities.

I’m not saying this isn’t an authentic narrative for some, possibly many, trans people. It’s just that the people for whom this narrative does not apply are often excluded from gender-affirming health care—care that could provide them a better quality of life or even save their lives. These people are not members of the slam dunk club.