Microaggression Detection in Psychotherapy: Expanding Affirming Care for Transgender and Nonbinary Clients

Abstract

Transgender and nonbinary (TGNB) people report experiencing discrimination from therapists. A step to reducing these microaggressions is for therapists to be able to identify them. Psychological trainees and psychologists (n = 105) were randomly assigned to watch a video vignette therapy session: a session with (a) blatant therapist microaggressions (nonaffirming), (b) therapist-led transition focus (transition affirming), and (c) gender exploration focus (nonbinary affirming). There was no difference in microaggression detection between the two affirming conditions. The microaggression condition of participants had a negative effect on ratings of therapist multicultural orientation (MCO). Additionally, attitudes towards transgender people moderated the relationship between microaggression conditions and ratings of therapist’s cultural humility for the affirming conditions; participants in the nonbinary affirming condition rated the therapist more culturally humble as their positive attitudes towards TGNB people increased, and participants rated the therapist as less culturally humble as TGNB attitudes increased in the transition affirming condition.