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Continuing a Conversation about Gender Identity, Ideology, and Social Work Practice

<Editor’s Note: In the Spring and Summer, 2017 double issue of Social Work & Christianity (SWC) , a special issue focused on Christianity and Social Work Practice with LGBTQ clients, Paul Adams wrote an article entitled, “Gender Ideology and the Truth of Marriage: A Catholic Perspective on Matters of Conscience in Social Work Practice with LGBTQ Clients.” To check out Paul’s article, go to: http://www.nacsw.org/Publications/SWC/SWC44_1&2AdamsArticle.pdf.

In response to Paul’s article, Dirk de Jong wrote a letter to the editor of Social Work & Christianity. With his permission, we shared Dirk’s letter with Paul, and Paul agreed to write a response, which we published alongside Dirk’s letter in the Fall, 2017 issue of Social Work & Christianity. To check out Dirk’s and Paul’s letters, go to: http://www.nacsw.org/Publications/SWC/SWC44_3LetterstoEditor.pdf.

To keep the conversation started by Paul and Dirk going, NACSW decided to post their exchange on this blog and invite readers to chime in with thoughtful comments of their own – posts that that give voice to the many competing values in play in this conversation, and that share how social workers’ views on these issues impact ethical social work practice while they model careful listening and learning from a variety of points of view expressed in both faith and social work communities.

This below introduction/invitation to this conversation was written by David Sherwood, who was the guest editor of the Spring, 2017 special issue of SWC in which Paul’s article was originally published.>


Part of me loves it when people talk like Paul Adams and Dirk de Jong do in this exchange about gender identity and ideology (and, honestly, part of me hates it). In this polarized time, we all need to beware of labeling and stereotyping those who disagree with us. I think we can see a bit of this in both Paul’s and Dirk’s responses. But both have important points to make.

Epistemological humility doesn’t mean that we can’t or shouldn’t come to clear beliefs and understandings. Rather, it requires that we know at a deep level that our fallen and finite minds can only approximate God’s truth and that our current paradigms will continue to need correction. This should not be just a debate about gender identity, ideology, and social work practice, but a mutual inquiry between brothers and sisters who seek to better understand and live the Truth of God.

I encourage you to carefully read all the materials in this exchange. These are matters that serious Christians and ethical, competent social workers need to be grappling with. I don’t think any of us wants to be captive of anyone’s agenda but Christ’s. I don’t want to be a thrall of either the “secular humanists” or the “reactionary religious conservatives.”

I hope that this exchange will encourage you to do your own reflecting and research and listen respectfully to those who hold views different from yours. I invite you to offer your thoughts on this matter in this facilitated blog discussion. Former NACSW Board member Rene Drumm will be the facilitator of this exchange.

I also hope some of you may develop systematic, empirical research that will test hypotheses. Some of you may write articles and submit them for publication (in Social Work & Christianity or elsewhere).

We need to hear your voice.

David Sherwood is the recently retired Editor in Chief of NACSW’s quarterly journal, Social Work & Christianity, and a retired professor of social work. He has been a member of NACSW for over 40 years.

6 thoughts on “Continuing a Conversation about Gender Identity, Ideology, and Social Work Practice

  1. Reviewing Dirk H. De Jong’s response to the Paul Adams article in Social Work and Christianity, one would think the article was about gender dysphoria. While there is some disagreement about gender dysphoria, what can be gleaned about gender dysphoria from both pieces is that the data are sparse, subject to variant interpretations, including the political.

    Adams is very clear that he wants to “set out the basic Christian understanding in its sharpest form to show its contrast, as a fundamentally incommensurable tradition, to the prevailing secularist orthodoxy (Adams, 150)”. De Jong’s response doesn’t really disagree with Adams’ illustration of the differences. Indeed, the heart of his analysis conforms to Adams’ understanding of “the prevailing secularist orthodoxy”. Their difference comes in their considerations of whether in the complexity of practice the evidence is sufficiently compelling to influence social workers’ practice. And here I believe De Jong has the more difficult task.

    Practice with issues of gender dysphoria in children is indeed a complex conversation of different understandings of reality – of clients, parents, children and teachers – and of social workers – all confronted by confusing and possibly politicized developmental understandings. The issues are complex and difficult. What to do? In the case of a minor child, what might be harmful to him or her? What is one’s responsibility? Where and how does one set limits? And what are the limits of each person’s conscience, including the social worker’s, in these practice situations? Where are the boundaries between “interference” (or support) in decision-making processes and potential harm to a developing person? Paradoxically, every day social work practitioners muddle through helping client systems sort through different issues they face, their conflicts and differences, toward what eventually seems best. In some ways, it isn’t new; in its interpretation it is new.

    Adams discusses the complexities of conscience in social work. We in social work have given little attention to conscience, and even less to the conscience of the social worker. Conscience, often confused with “values” and preferences, is much more important than vague convictions. It is the concrete, practical judgement, all things considered, about the right thing to do (Adams, 134). This judgement includes each person’s developed understanding of morality, of themselves and others, of the situation, what they should do in the situation, and what they want to achieve. The social work principle of client self-determination, unchanged in the 2017 Code, makes it clear that, within limits, the decision is the client’s (or with minors, the client system). The social worker can help in this process, and there are some limits to what can be supported:

    Social workers respect and promote the right of clients to self determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self-determination when, in the social worker’s professional judgement, clients’ actions or potential actions pose a serious, foreseeable and imminent risk to themselves and others(NASW, 2017).

    The social worker is not imposing an ideology or a morality. Respecting clients as moral agents means that social workers respect their own moral agency as well. When two or more agents are involved in the conversation of practice, neither the client(s), nor the social worker should become an unconsenting means to another’s end. The social worker’s responsibility for what the other does is limited to the assistance implicitly or explicitly provided in facilitating the client’s intentions (Constable, 1989, p. 65). Otherwise social workers would be required to forfeit their own moral agency or violate their consciences to carry out the will of the client. In any case, it is the client who acts. In the concrete drama of practice, the social worker is always implicitly (and genuinely) choosing to support or not support, to confirm or not confirm, to facilitate or not to facilitate, to assist the other(s) to find their solution (Constable, 2013, 122). In the relationship I can accept very different perspectives without agreeing or facilitating them (Biestek, 1957). In any case the relationship is in part a product of the social worker’s own authentic, professional and personal conscience. My conscience brings me to accept and respect the other’s differences, but I may not facilitate something harmful to others. If this were staged or artificial, it would quickly become apparent to the other. All of this takes time to develop, and the details of how this takes place is another conversation. The ballet dancer works hard to develop spontaneous movement.

    Adams is a realist with regard to the dilemmas implicit in present situation, particularly for the Christian social worker. He considers the present situation “immensely more hostile to religious liberty”, with coercive policies which “represent a transition from culture wars to conscience wars (Messner, 2011). On the other hand, given the nature of client self-determination, some issues are resolvable in concrete practice; while some would demand another worker to take over. We will never be competent to do everything. Since differences do occur in any case, none of this is particularly earth shaking. There are ways to resolve them. Adams’ contribution is to resist the drive by activists, courts and legislators to override professional judgement, often the client’s own perceptions and conscience by mandating or prohibiting certain interventions, and indeed to impose single, crude, ideological models on the complexity of practice. For obvious reasons, the Code of Ethics doesn’t expect collaboration with whatever a client system may desire, as is often popularly assumed (Constable, 2013, 123). It does expect social workers to “assist clients in their efforts to identify and clarify their goals”. And it proscribes anything that would pose a “serious, foreseeable and imminent risk to themselves or others”. Primum non nocere. In any case. social workers should not be forced to lie as a condition of keeping one’s job, career or business (Adams, 162). He upholds the professional principles of first doing no harm and of informed consent (Adams, 165). His aim is that the thick and complex morality of social work practice, as well as the uncertainty and human spontaneity of it, be upheld.

    Adams, P. (2017) Gender Ideology and the Truth of Marriage: The Challenge for Christian Social Workers. Journal of Social Work and Christianity. 44(1&2) 142-169.

    Biestek, F. J. (1957) The Casework Relationship. Chicago: Loyola University Press.

    Constable, R. (1989) Relations and Membership: Foundations for Ethical Thinking in Social Work. Social Thought. XV(3&4) 53-66.

    Constable, R. (2013) Social Workers, Conscience Protection and Practice. Journal of Religion & Spirituality in Social Work: Social Thought.32(2) 114-130.

    De Jong, D. H. (2017) Letter to the Editor: The Truth behind Gender Ideology. Journal of Social Work and Christianity. 44(3) 135-140.

    Messner, T. M. (2011) From Culture Wars to Conscience Wars: Emerging Threats to Conscience. Heritage Foundation.

    NASW (2017) Code of Ethics; 1.02 Self Determination.

    Robert Constable
    Professor Emeritus
    Loyola University Chicago

    1. I believe that conversations about the role of conscience and one’s beliefs about truth with respect to social work are interesting and useful conversations to have. However, they would most likely seem less interesting and useful to clients who are hurting. Historically, transgender persons, youth included, have experienced high rates of victimization and self-harm. Current best practice, based on research rather than a so-called “gender ideology”, includes interventions that can reduce these rates significantly. They are not coercive and they do not come at the expense of “truth”. Social workers need to learn about them, not prejudge them.

      1. For those of us who are interested in these interventions to reduce victimization and self-harm, where should we start?

        Also, it is so easy for most of us to prejudge just about anything new/different. What suggestions would any of you following this conversation have about how to avoid the judgment trap?

  2. Hi Rene,

    Thanks for asking these excellent questions. In terms of a comprehensive overview of interventions, I would suggest looking at the Standards of Care, Version 7, published by the World Professional Association of Transgender Health (WPATH). You can download it from their website. As described on the website, "WPATH has established internationally accepted Standards of Care (SOC) for the treatment of gender identity disorders. These internationally accepted guidelines are designed to promote the health and welfare of persons with gender identity disorders. The Standards of Care are updated and revised as new scientific information becomes available". Also, a good introductory resource is Transgender 101: A simple Guide to a Complex Issue, by Nicholas Teich. As far as the judgment trap is concerned: In my opinion, the best way to avoid it is to talk with transgender and gender-variant people and to learn about their experiences.

  3. Hi, Dirk, Renee, Protocols, within the competence and training of social work, are useful to the extent that they represent some tested experience working with person(s)/environments/ circumstances analogous to the person(s)/families we are working with. However, no protocol can obviate the realities of the person(s), environment(s)/ situations and the decision-making process(es) taking place. In every particular practice situation; this is, among other things, a conversation of consciences. And so, the above discussion (and criteria) do apply, even more urgently because there can be a tendency to downplay these parts of practice, and thus restrict the freedom of the client system to address their concerns with themselves and with each other, and the freedom of the social worker to find ways to address the situation in a way that is helpful and that avoids harm.

  4. Hi Robert,

    I agree that tested protocols need to fit the client's environment / situation. However, the value of research cannot be minimized by ideological considerations. In that context, the Trump's administration's apparent directive to the CDC to delete certain controversial words from policy analyses is both informative and worrisome. According to a report in the Washington Post, these words are "vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based". Obviously, the CDC is an agency charged with the scientific investigation of health issues. The Washington Post article shows the danger of allowing ideology to bias this mission. I think the same concern applies to the mission of social work. Yes, it is a profession influenced by values. However, that should not come at the expense of science.

    Here is the link to the WP article:

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