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Experience of career-related discrimination for female-to-male Transgender persons: a qualitative study.

In this qualitative study, the authors examined the experience of discrimination and its relationship to the career development trajectory of 9 female-to-male transgender persons. Participants were between 21 and 48 years old and had a variety of vocational experiences. Individual semistructured interviews were conducted via telephone and analyzed using grounded theory methodology. The emergent model consisted of forms of discrimination and impact of discrimination. These components intersected with the career development trajectory. Participants provided their own suggestions for improving the workplace environment. Counseling, advocacy, and future research implications are discussed.

Keywords: female-to-male, transgender, career, discrimination, qualitative

Considerable attention has been given to the topic of career-related discrimination for lesbian, gay, and bisexual (LGB) persons (Chung, 2001, 2003; Chung, Williams, & Dispenza, 2009; Lidderdale, Croteau, Anderson, Tovar-Murray, & Davis, 2007; Raggins & Cornwell, 2001; Smith & Ingram, 2004; Waldo, 1999). However, research on discrimination is still in its infancy concerning transgender persons, a group that is often linked with LGB persons in the counseling and psychological literature. Individuals who identify as transgender, an umbrella term that refers to any person whose gender identity expression does not align with traditional gender norms, do not necessarily associate with the gender they were assigned at birth (Pepper & Lorah, 2008). In addition, the term transgender is used to encompass other related identities, such as transsexual, cross-dresser, transvestite, gender queer, drag queen/drag king, trans-man, trans-woman, female-to-male (FTM), and male-to-female (MTF).

Pepper and Lorah (2008) asserted that transgender persons are a stigmatized population and that their career development processes are also likely affected by discrimination. O'Neil, McWhirter, and Cerezo (2008) maintained that transgender persons experience sex-based discrimination within the workplace, including hostile comments, employee refusal to use preferred names or pronouns, as well as refusal to allow transgender persons to use restrooms that match their gender identity, Despite the current awareness to understand the career development of transgender persons by career counselors and researchers, the experience of discrimination for transgender persons is not well understood in the context of career development.

King (2005) reported that discrimination is a significant stressor that has been associated with psychological distress and even physical illness. Transgender persons are at risk for experiencing low self-esteem, depression, anxiety, loneliness, substance use issues, and other compromises to psychological functioning as a result of discrimination and oppression (Clements-Nolle, Marx, & Karz, 2006; Gainor, 2000; Irwin, 2002). Rachlin (as cited in Pepper & Lorah, 2008) noted that transgender clients seek counseling and psychotherapy because of workplace conflicts and concerns. Thus, as a contextual factor, it is important for career counselors and interventionists to understand the different experiences of discrimination and how discrimination affects transgender clients. In addition, it is important to understand how discrimination outside the work environment could potentially have an impact on the career development trajectory.

Although employed transgender persons work in a variety of settings around the world, Kirk and Belovics (2008) contended that transgender persons also endure vast amounts of employment discrimination and unemployment. Minter and Daley (2003) stated that underemployment is another significant issue with the transgender community, because many of these individuals may not be able to find enough work or earn enough money. A report released by Badgett, Lau, Sears, and Ho (2007) from the Williams Institute on Sexual Orientation Law and Public Policy provided a summary on LGRT experiences in the workplace. When specifying the work experiences of transgender persons, the report indicated that 15%-57% of transgender persons experienced some form of employment discrimination. They summarized six other studies that were conducted between 1996 and 2006 and found that 13%--56% of sampled transgender persons were terminated from their jobs; another 13%-47% of transgender persons were denied employment on the basis of their gender orientation and expression; 22%-31% were harassed at their place of employment; and another 19% were denied a promotion because of their gender identity (Badgett et al., 2007).

Lombardi, Wilchins, Priesing, and Malouf (2001) collected representative data across the United States and operationalized instances of transgender persons being fired, not hired, demoted, or unfairly disciplined in the workplace as economic discrimination. Lombardi et al. found that 37.1% of transgender persons experienced some type of discrimination in their lifetime. A series of logistical regressions showed that economic discrimination was, more alarmingly, a significant predictor of experiencing other violent incidents (e.g., rape, assault, and verbal and physical harassment). The authors concluded that
  while it is possible that economic discrimination could lead to a
  greater likelihood of experiencing violence, it is more likely that
  a pervasive pattern of discrimination, and prejudice exists for
  transgender people which can influence their experiences of both
  economic discrimination and violence. (Lombardi et al., 2001, p. 98)


The results from Lombardi et al. (2001) support the view that being fired and denied employment are definite measurable outcomes of discrimination toward transgender persons; however, transgender persons experience discrimination long before they are ever fired from a job or denied employment.

The purpose of this grounded theory study was to illuminate a model of discrimination experienced by FTM transgender persons in the context of the career development trajectory. Chojnacki and Gilberg (1994) conceptualized work discrimination as multidimensional, or multilayered, and it is important for career counselors and interventionists to understand how multilayered experiences of discrimination may potentially affect transgender persons. Sanchez and Villain (2009) reported that much of the extant research on the transgender community has focused on MTF; thus, it could be argued that the voices of FTM persons are not appropriately noted in the literature. In addition, the experiences of FTM and MTF transgender persons is sometimes combined in research, perhaps obfuscating how-discrimination may be experienced by FTM transgender persons. For example, FTM transgender persons may experience sexism or they may be viewed as challenging conventional patriarchal values of male gender identity and expression. Thus, more research is needed to understand FTM transgender persons' experiences with discrimination and how it intersects with their career development trajectory. The research questions that guided our study were the following: What are some forms of discrimination experienced by FTM persons, and how do these discriminatory experiences influence the career development trajectory?

Method

Research Design

We used a qualitative design to best answer the research query. Qualitative approaches are exceptionally suitable when studying underrepresented or marginalized populations, and qualitative approaches have gained popularity over the years for this reason (Bogdan & Knopp Biklen, 2007; Fassinger, 2005). Given that the research questions were aimed at discrimination, and the current literature refers to issues in the workplace as economic discrimination (Badgett et al., 2007), critical inquiry was used as the theoretical perspective guiding this qualitative study. Composed of a variety' of theories, critical inquiry focuses on the societal power dynamics that interact with marginalized groups, while attempting to further understand how existing injustices are endured by such groups (Grotty, 1998). Finally, there is precedence in the sociological literature that has used both grounded theory and the critical tradition to better understand the experiences of transgender persons (Ekins, 1997). Permission from a university institutional review board was granted prior to data collection.

Researcher-as-Instrument

All five members of the research team had counseling, advocacy, and research experience with diverse groups (including LGBT persons) before this study began. Two members of the research team identified as doctoral students in counseling psychology, another was a master's student in counseling, and the remaining two members identified themselves as university professors. Four of the research team members self-identified their cultural background as White/European American, and the fifth team member self-identified as Asian American. Four of the research team members self-identified as male, and one self identified as female. Although no one on the research team identified as transgender, all members identified as transgender allies. Finally, all of the researchers had been involved in a variety of research projects that included both quantitative and qualitative methodologies, and two members of the research team had previous experience and training with grounded theory methodology.

Throughout a series of working meetings, the first and second authors of this study disclosed their biases and subjectivities prior to data collection and throughout data analysis. Biases were bracketed, and the first author used memo writing as a method of keeping track of these assumptions and subjectivities (Bogdan & Knopp Biklen, 2007). Assumptions discussed were that (a) not all transgender persons will experience the same forms of discrimination and (h) not all discrimination directly relates to the career trajectory. In addition, it was discussed that all persons possess different value systems when it comes to career, that the career developmental trajectory is likely to vary for each person, and that discrimination may potentially be the outcome of other factors such as race, ethnicity, education, and socioeconomic status.

Participants

A total of nine participants were used for this study. Inclusion criteria required that participants were at least 18 years old, identified as trans-gender, and possessed some work and/or education experience. Ages of participants ranged from 21 to 48 years (M = 33.22, SD = 8.91). Regarding racial and ethnic diversity, six of the participants self-identified as White/Caucasian, one identified as Pacific Islander, one self-identified as half Native American and half White, and another self-identified as half White and Middle Eastern. Participants identified that they were born biologically female, and each identified being in different stages of the transition process (i.e., just beginning hormone therapy, preparing for top surgery, or had successfully transitioned for several years). At the time of the interview, six identified their gender as male, two identified as trans-gender male, and one identified as gender queer. Four participants had earned a professional or graduate-level degree (e.g., master's, doctorate, juris doctor), one was completing a graduate degree, one had earned a baccalaureate degree, one was completing a baccalaureate degree, and two had no college degree. They were all employed at the time of the interview and were in a variety of work settings that included education, social service, health care, real estate, the food and beverage industry, law-enforcement, cosmetology, information science, and retail. Three participants were involved in more than one form of work at a time, and two were attending school while simultaneously being employed part time.

Participants were located in four different geographical regions of the United States. Four were in the Northeast, three in the Southeast, one in the Midwest, and one was located on the West Coast. Information regarding family and relationship status was collected at the time of the study: Five participants indicated that they were single, two participants were partnered with a biologically born female, one was partnered with a biologically born male, and one was partnered with a FTM individual. Three participants had children who were biologically born to them prior to the transition process, and one participant was a stepparent. Although participants described their sexual orientation/romantic statuses, we did not include questions that asked the participants to label their sexual orientation. Information regarding income was not collected during the interview process because of researcher oversight; however, none of the participants reported income as a concern.

Instruments

The primary instrument used to gather data was a semistructured interview protocol (see Appendix for sample questions and probes). Semistructured interviews allowed for some consistency in data collection between participants and also gave participants the opportunity to expand on their responses. The protocol questions were developed by a research team; then a FTM transgender person (not interviewed for this study) reviewed and provided feedback on the questions for appropriateness prior to the use of the interview protocol. Demographic information, such as age, gender, employment history, educational history, volunteer experience, and avocational interests, was also collected.

Procedure

Qualitative interviews were conducted with nine persons. Although grounded theory calls for theoretical sampling (Fassinger, 2005), convenience and snowball sampling were used to select participants (Bogdan & Knopp Biklen, 2007; Patton, 2002; Schensul, LeCompte, Natasi, & Borgatti, 1999). Similar to sampling procedures conducted by Singh, Hays, and Watson (2011), participants were recruited via Internet postings and online transgender listservs. We used a modified sampling procedure because it can be difficult to access transgender persons for research. Potential participants were informed that researchers from a major university located in the southeastern portion of the United States were conducting a free and voluntary interview study on the career development and work-related experiences of FTM transgender persons. Potential participants were also informed that researchers were interested in learning more about any joys or difficult experiences that were incurred throughout the career pathway. Similar interview protocols (see Appendix) were administered to each participant and modified accordingly in order to receive rich information (Noonan et al., 2004). Each interview was conducted by the first author, lasted approximately 60 to 70 minutes, and was conducted via telephone using a recording device. Telephone interviews were conducted to better access participants living in geographically distant regions. Informed consent was gained from the participants

before the interview was conducted. Redundancy of codes was used as the primary criterion to cease sampling for this study (Merriam, 2009). We believed saturation was reached when there was a lack of any new information emerging from the last two interviews.

Data Analysis

All interviews were recorded on an audiocassette tape and were then transcribed. Principles of grounded theory were used to analyze the interviews and involved open coding, axial coding, and selective coding (Fassinger, 2005; Strauss & Corbin, 1998). The first and second authors individually coded the first three transcripts to develop a list of primary themes (i.e., open coding). A coding manual was developed on the basis of these primary themes to help guide coding of the additional six transcripts. Coding additional transcripts yielded subthemes of the primary themes (i.e., axial coding), providing further clarification of PTM transgender persons' experiences with discrimination and the effects on their career development trajectory. During this phase, several different codes were collapsed and discrimination emerged as the main code. The coding manual was edited to reflect the changes among the codes. The process of selective coding identified specific codes that further supported discrimination and helped to establish a model of participants' experiences with discrimination and how this affected their career development (refer to Results section). All codes were determined by consensus. Differences of opinions and perceptions of codes were resolved through consensus, with the third and fourth authors designated as mediators for the consensus process.

Verification standards were used to establish trustworthiness of the data, First, rich and elaborate responses were collected from each participant. Second, the primary interviewer debriefed with members of the research team after each interview, while also using journaling and memo writing as a means of tracking thoughts, reactions, and reflections from the interviewing and coding phases. Third, an audit trail was maintained throughout the project and data analysis phases. Finally, we used negative case analysis to find alternative conditions in which the emerged codes were not evident in other parts of the data (Hesse-Biber & Leavy, 2006).

To establish credibility of the data, various forms of member checking were used. Participants were sent information regarding the results presented in this article and asked to provide any corrective feedback or insights regarding the results. One participant provided additional feedback. In addition, some data were presented at regional conferences and community outreach programs. Attendees at these conferences and programs (e.g., counselors, researchers, advocates) were asked if they had any personal knowledge concerning discrimination with the transgender community, and several confirmed some of the results that are reported in this article. A member of the research team who was not an author of this article audited the final codes and confirmed that the codes appropriately emerged from the data.

Results

An emergent model illuminating the experience of career-related discrimination for FTM transgender persons is represented in Figure 1. Discrimination emerged as the primary category. On the basis of the descriptions provided by participants, we conceptualized discrimination on a continuum in order to capture a full range of injustices. Furthermore, discrimination was defined as an inequity, bias, or intolerance on the basis of one's transgender identity. As represented by the arrows in Figure 1, the experiences of discrimination consisted of forms of discrimination and impact of discrimination. Participants in the study identified eight specific forms of discrimination that directly influenced their work experiences or career development trajectory: microaggressions, horizontal oppressions, discrimination by health care systems, discrimination by government policies, threat to patriarchy, discrimination by social supports, discrimination by housing, and discrimination by educational institution. Because of their discrimination experiences, participants also described the impact of discrimination. These impacts were stress and coping. The coping behaviors described by the participants were helpful in reducing the stress related to discrimination; in some instances, certain coping behaviors were used to directly combat a particular form of discrimination (e.g., proactive resistance was used to help cope with the experience of horizontal oppression).

[FIGURE 1 OMITTED]

The components that comprise the emergent model are described in more detail later in this section of the article. We also asked participants to provide any suggestions that they believe would help improve workplace environments for transgender persons, and those results arc also presented later in this section. Direct quotations are provided for descriptive purposes, and a notation system similar to the one used by Richie et al. (1997) and Gomez, Fassinger, Prosser, Cooke, and Mejia (2001) was used to indicate the number of participants who consistently reflected similar model components. The words most, majority, many, and often were indicators of seven or more participants, whereas words such as some, several, and a number of indicate four to six participants. The word few indicates responses from three or fewer participants.

Forms of Discrimination

Microaggressions. Consistent with the existing literature on racial microaggression (see Sue et al., 2007), microaggressions were subtle and sometimes emotionally charged experiences that went encountered by the majority of the participants in this study. Some participants mentioned that these experiences could be difficult to articulate, and in some instances included nonverbal exchanges between a participant and a workplace colleague. A participant who was employed in a professional office setting described the following situation with his employer:
  I don't think he [the employer] ever knew what to make of me,
  so he would give me tips on how I should dress. Did he think
  I was 12 years old or something and can't figure it out? When
  I would go to conferenees, he would make sure that I wore khaki
  pants and a blazer. Some people I worked with would ask me,
  "did he tell you if you should wear boxers or briefs too?"


Another participant working in a social service office described what it was like to have people in the workplace who were not supportive and were unwilling to understand his transgender identity. He reported, "I've had people at work that like to debate with me about myself. People will ask me, 'what are you legally?'"

Horizontal oppressions. Majority of participants described circumstances of being discriminated against by members of the LGB community because of their gender. Many of these experiences were directly related to work, employment, or the individual's support system. One participant, who was a cosmetologist, revealed,
  I was interviewing to be a front desk person at a salon and die
  interviewing manager there loved me. It happened to be char the
  salon was owned by two gay men, and when they found out that I
  was being considered for the job, they freaked out. I didn't
  get the job. They were worried that I was going to be an issue
  with the clients because of my gender.


Another participant, who had earned a doctoral degree, shared that horizontal oppression had a direct impact on policy and legislation within his county. He relayed the following experience:
  There was this group of middle-aged lesbians and gay men that
  strongly advocated against gender identity and expression to
  be added in this piece of legislation in my county. They
  strongly advocated against gender identity and expression
  and said "we don't want these transgender people--they're not
  like us, and if we try to and it in, we won't get this
  antidiscriminatory legislation passed."


However, horizontal oppression did not exclusively occur within the LGB community, according to participants in this study. There were instances when participants were discriminated or felt oppressed by MTP transgender persons. Although this was not a common occurrence among die HTM participants in this study, several participants reported feeling "less than" or "less important" than MTV transgender persons. One participant mentioned experiencing discrimination by both members of the MTF transgender community and the lesbian community. He also perceived "a lot of bullying" from the MTF community.

Discrimination by health care systems. A few of the participants perceived discrimination by institutions that provided health benefits, such as insurance companies; other participants discussed the difficulties they encountered when they accessed actual health care by medical clinics and physicians. All of the participants who talked about the difficulties related to health care emphasized the potential long-term effects regarding the quality of life with and without health care. One participant said:
  My biggest issue and the most stressful factor related to
  being transgender is that when I'm old and put in a hospital,
  they'll probably put me in the woman's ward. I see it now; and
  they treat people like shit. God forbid I end up in the veteran's
  home. This one person that my organization went to rescue from
  this--and she died a week later after we found her--they just
  left her in her own filth. They wouldn't even clean up after
  tier because they thought she was a freak.


Discrimination by government policies. This code included discrimination on both the federal and state government levels. Many participants described instances of discrimination because of a lack of policy or protective law that failed to account for gender variance. For some participants, these policies or lack of policies served as a barrier to the transition process. As one participant said,
  I'm trying to get a passport right now, and the law of the state
  requires mc to have all my ducks lined up in the same row--all
  your genders have to be the same on everything, and my birth
  certificate still says female. In order to change your gender
  on your birth certificate you have to say that you have had a
  hysterectomy or some sort of bottom surgery. Top surgery is
  not enough. And so, I now need to basically fight for the
  "M" on my passport.


Another participant discussed the link between government policies and the employment initiation process, noting that legal documents such as driving licenses and federal passports are needed to proceed with paperwork and conduct background checks.

Threat to patriarchy. This code emerged because several participants reported (a) appearing and feeling less visible in the transgender community and the community at large and (b) sometimes experiencing some form of discrimination (i.e., sexism) for being a FTM transgender person. Some of the participants suggested that their gender was a threat to the patriarchy and that social supports and various institutions perceived that some of the participants had "acquired" male privilege. As one participant who was employed in retail said,
  I definitely feel we challenge patriarchy, and a huge problem
  is that we are not as generally accepted as much. I think
  trans-men were and are still not as visible as trans-women
  ... and we are considered second-class to a lot of the
  trans-women or trans-female.


Another participant added,
  There are a lot more resources out there for the MTF community
  than there are for FTM; finding a good surgeon that is even
  mildly affordable is difficult, as prices are definitely higher
  and more difficult for FTM.


Discrimination by social supports. This code emerged since many participants described experiencing discrimination directly by family members, romantic partners, and friends. Two of the participants in the study reported no conflict or strained interpersonal relationships with friends, romantic partners, and family as a result of their trans-gender identity; however, many reported strain among their various social supports. With regard to revealing his transgender identity to his family, one participant, who was completing his baccalaureate degree during the time of the interview, shared that the experience
  didn't really go over really well. My mother and stepfather had
  a negative response, and, after that, we just had a "don't ask,
  don't tell" relationship. Afterward, I was kicked out of my
  house and sent to an ex-gay/ex-trans camp that are ail over
  the country. My parents threatened to pull me out of college
  if I did not agree to go to this camp.


When they revealed their transgender identity, some of the participants reported that they either significantly limited their communication with friends or family, or in some cases, completely disconnected themselves from certain relationships. A few of the participants mentioned having to terminate their romantic relationship as a result of transitioning. One participant indicated that the only person who had a profound negative reaction to his transgender identity was
  my partner, who broke up with me because I came out as
  transgender. My partner at the time was really invested in
  being identified as a lesbian, and all of a sudden I come
  out as transgender, and what does that mean for her identity?


Discrimination by housing. A few of the participants reported difficulty with accessing or maintaining residential living facilities. A recently-graduated college student during the time of this study reported issues gaining accessible university housing because the university did not have appropriate policies or living facilities for individuals who identified as transgender. At the time of the interview, this participant mentioned that he had a colleague who was "currently working with the university housing department in order to develop gender neutral housing. But the process keeps getting postponed, and I think that is ridiculous because people need a place to go and live when they're going to school." A second participant described an incident of harassment by his landlord that resulted from his transgender identity. He stated,
  My landlord found our that I was transitioning, and as soon
  as he found our, he started harassing us [children and spouse]
  and threatened to throw us out of the house. He spit on me,
  called me "White trash," and he told me that he didn't warn
  people like me living in his neighborhood.


Discrimination by educational institutions. Although several participants mentioned that they experienced little difficulty navigating their educational institutions, a few of the participants disclosed issues dealing with negative reactions from students, teachers, and college professors as they were transitioning. In some instances, participants mentioned being "harassed by schoolmates." This code emerged more fully when one participant believed that he was not allowed entry into a graduate program because of his transgender identity. He stated,
  The second 1 left the institution for my orientation, they
  rescinded my acceptance. It was at the point that I left
  that they began doing paperwork to rake back my acceptance.
  They didn't tell me until June, after I accepted in April.
  I called a friend who was in that department, and he told
  mc that they thought I was weird. I went in wearing pants
  and a sports coat, and I think they were expecting me to
  wear a skirt.


Impact of Discrimination

Stress. All participants in the study reported some type of stress as a result of actual or perceived discrimination. Participants specifically mentioned feeling anxiety, depression, and apprehension; two participants reported feeling overly cautious around others because of persistently experiencing discrimination. One participant described the stress of discrimination as "pretty excruciating, sinister, the worst of human being behavior." Another participant mentioned that the stress of losing work was so bad that "I almost became homeless, broke up with my partner, and was under the most unbelievable amount of stress for 2 months." Other participants described withdrawing from people and struggling with depression because they were always "stressed out" about gender identity. One participant stated that during his high school years, the depression was "so bad that I attempted suicide because I was being harassed by school mates." In relation to taking hormones, another participant reported,
  There was always a lot of stress, especially when I first
  starred to take hormones. It was extremely stressful,
  because I never knew what people thought of me, especially
  at work, or how they made sense of what T was doing, or
  what I was going through. They responded to me based on
  what they thought of me, and I had to figure out how to
  respond back. I was always really anxious about that. I
  would begin lo question, "What is my place in the world?"


Coping, Despite enduring profound stress, all participants disclosed that they used coping-related behaviors and resources in order to manage the impact of discrimination. Particular coping behaviors included counseling, using support groups, taking part in avocational interests and activities, family and friends, and proactive resistance. Although few participants used counseling, several relied on affirming friends and family to help them cope with the various forms of discrimination that emerged as a result of their gender identity. Two participants reported that they used transgender support groups, whereas many others relied on their avocational interests (e.g., volunteering, reading, advocacy, art work) to help cope with stress. Two participants mentioned having the opportunity to "fight back" as a way to cope with the stress and to directly counter the discrimination the" experienced. To cope with the stress associated with an employer developing a special policy that prohibited any cross-gender dressing in that workplace setting, one participant used a form of proactive resistance and stated,
  I fought. I was thoroughly obnoxious. I worked there for a
  year and a half, and got a good year end review. The minute
  I got the letter, I wrote them a letter, and basically said
  that this is discrimination and you have to reverse your
  little policy that you made up special for me.


Suggestions for Improving the Workplace Environment

To advocate via research for transgender persons, we believed that it was appropriate to highlight some of the participants' suggestions for improving workplace environments. First, participants mentioned that having unisex bathrooms would be helpful for individuals who are in the process of transitioning. They also believed that such bathrooms would be a significant benefit for other individuals who did not identify as transgender, such as individuals with special needs. Second, having a representative in an educational or employment organization who has received training on transgender issues may be helpful because that person could help trans-gender individuals better navigate work and school environments during the transitioning process. Such help might include educating coworkers about transgender issues, assisting with documentation, or helping others adjust to name (and pronoun I changes. Some participants indicated that having friendly, employer-sponsored health care or insurance programs would also be beneficial, particularly because the transition process requires a considerable amount of financial and medical resources.

Discussion

Being terminated, denied employment, and harassed are experiences that FTM transgender persons deal with in the workplace, but the participants from this study revealed that there are other forms of discrimination that have influenced their career development trajectory. Discrimination is pervasive and permeates various aspects of a transgender person's life. In diseussing career development, Kirk and Belovics (2008) asserted that transgender persons may need help with self-assessment, career exploration, decision making and planning, job search, and interviewing. Microaggressions, horizontal oppression, discrimination by health care systems and government policies, threat to patriarchy, social supports, housing, educational institutions, as well as stress and coping, affected how the FTM transgender persons interviewed for this study self-assessed, explored, and made decisions about their own career development.

Although discrimination in an individual's personal-social life and in the workplace can be explicit, this study revealed some implicit forms of discrimination. Microaggressions against the FTM persons in this Study occurred frequently and by numerous people in the workplace. Although the microaggressions could be deemed highly offensive, there appears to be little recourse, given their subtle nature (Sue et al., 2007). Other individuals would likely not recognize that microaggressions were being committed in the workplace, and long-term effects of microaggressions on transgender persons currently arc not well understood. There seems to be a belief that certain minority groups would be supportive of other minority groups; this was not always the case with the participants in our study. Horizontal oppressions were experienced by these participants and resulted in difficulties when they attempted to establish supports or allies with other minority groups. In this study, horizontal oppressions were shown to affect persons attempting to gain access to employment and community support. Some transgender persons also believed that they vere oppressed by other transgender persons. The emergence of horizontal oppressions further reflects the difficulty for minority groups in accessing equal rights in the workplace and in society at large and further indicates the level of competition that is bound to surface when two minority groups attempt to gain the same rights in the United States.

Government, educational, and health care institutions also promoted discrimination according to the FTM transgender persons in this study. How could any individual optimally perform if there are institutional barriers (e.g., policies, hostile environments) that withhold basic necessities from an individual? It was difficult for some of the participants in this study to perform effectively as a worker or student, that is, to meet the demands of the school or work environment, when health, psychological, and physical well being were compromised. In some instances, government policies and educational institutions kept individuals from maintaining employment or receiving the appropriate protection needed to foster learning. In addition, discrimination by health care systems had some strong implications for the aging and retiring aspects of the career development process for a few of the participants; this issue should not be ignored because the transition process could require lifelong medical attention. Whether it is the prohibition of certain documents needed in order to access employment, a lack of policies that protect transgender persons from being discriminated against, or receiving inappropriate health care services, it is important to understand that the discrimination experienced by the FTM persons in this study was potentially the outcome of larger systemic forces.

There were other forms of discrimination that influenced the participants of this study, such as feeling like a threat to patriarchy, discrimination from social supports, and discrimination in housing. In this study, one of the participants defined patriarchy as any institution that has been traditionally guided by masculine values. As noted by other study participants, this form of discrimination was particularly apparent in the context of resources (e.g., health, medical, social policy), which participants perceived as less available to FTM persons because of their transgender male status. Participants mentioned being perceived as if they had "acquired" male privilege, and acquisition of this privilege could be deemed menacing to the larger society. Discrimination from social supports could have an impact on the perceived quality and satisfaction an individual has in interpersonal relationships. As evidenced by many of our participants, dissatisfaction was present when they experienced discrimination at work and from friends, family, or loved ones. Housing was another significant discriminatory factor, and it not only affected participants' potential for obtaining an education, but the emergence of this code also revealed that personal safety was compromised within the participants' residential community.

Consistent with the literature (see Clements-Nolle et al., 2006; Irwin, 2002; King, 2005; Gainor, 2000), our results revealed that there were significant psychosocial factors that contributed to the health and well-being of transgendcr persons. Participants reported that stress was the most significant response to gender identity discrimination and that prolonged stress was connected to anxiety and depression. Some of these results converge with other studies that have examined the career development experiences of minority' groups (Gomez et al., 2001; Noonan et al., 2004). The participants in our study used various methods of coping with the stress caused by discrimination, suggesting the presence of resiliency and personal strengths that may have developed across their life span.

Limitations of the study need to be taken into account. First, our sample was limited in size and racial/ethnic diversity, so it was difficult to fully capture how gender and race influenced the experiences of discrimination for FTM transgendcr persons. It is important to capture this phenomenon in future research. Second, some scholars of qualitative research prefer to collect multiple data points (i.e., triangulation; see Bogdan & Knopp Biklen, 2007). Given the lack of quantitative measures when this research began, it was not possible to collect multiple data points. Therefore, in-depth interviews were used to better understand the experiences of discrimination. Finally, participants in this study volunteered to talk about their work experience; thus, there may have been individuals who chose not to volunteer because the study focused on transgender identity and work. There may be experiences in the workplace that are not yet understood.

Implications for Counseling and Advocacy

The results from this study show that transgender persons face multiple forms of discrimination within the career development trajectory. Therefore, a thorough exploration of these forms may prove beneficial when processing the experience of discrimination. Having transgender clients reflect upon their own levels of critical consciousness may help validate their discrimination experiences. Counselors may also find it helpful to reflect upon their own levels of critical consciousness and consider how discrimination outside the work setting could intersect with the career development process. Because discrimination has a way of silencing and oppressing marginalized persons, counselors could use a series of reflective and refraining methods with clients to empower transgender persons to be agents against the oppressive forces that pervade their lives. In addition, counselors may have to modify their approaches to intervention because the experience of discrimination may vary according to the developmental period of the individual during the transition process mm] the environmental context that surrounds a transgender person. However, research regarding career counseling practice with transgender persons is still limited and, thus, counselors are encouraged to exercise caution when making a clinical judgment.

Stress, anxiety, fear, anger, and depression are just some of the emotional states that the participants in this study experienced as a result of discrimination. It is essential that counselors screen and assess for these potential outcomes as a result of discrimination and help transgender persons identify adequate support systems and coping strategies to deal with these emotions. Counselors and interventionists should discuss the development of these emotional states within the framework of discrimination and not as the result of one's transgender identity and expression. It is also recommended that counselors integrate an appropriate level of cultural responsiveness into their practice. Because the experience of career-related discrimination could be compounded with aspects of culture, class, ethnicity, ability status, and sexual orientation, interventions and assessments may need to be tailored to account for the many identities a FTM transgender person may possess. These recommendations for counseling could also be applied to M IF transgender persons.

Counselors and interventionists working with this population should become knowledgeable of federal and state laws so that they can understand some of the difficulties experienced by transgender persons; this is especially relevant for professionals who provide employment-related counseling. (For information on laws and ordinances regarding transgender inclusion in the workplace, refer to Human Rights Campaign Foundation, 2008.) It is essential to establish transgender affirmative resources and referrals that include both legal and medical practices that serve transgender persons. It is also important for counselors to keep a referral log that includes local as well as national resources. Some of the participants in our study used services in other states because of the reputations of certain doctors. Several participants reported that they relied on the Internet for support and connection with others in the transgender community. In light of this, it may be helpful for counselors and interventionists to be Internet savvy. O'Neil et al. (2008) provided a list of Internet resources that counselors may find useful when working with transgender persons.

It is also important to advocate for transgender persons in the workplace. Career counselors and interventionists could provide educational services to supervisors, human resources personnel, and other workplace employees regarding transgender persons (see O'Neil et al., 2008). Topics such as (a) how to appropriately communicate about the transition process with transgender persons, (b) how to address pronoun and name changes of transitioning employees, and (c) how to accommodate work schedules for individuals who are undergoing routine medical procedures could be explored. In line with the tradition of critical inquiry, career counselors and interventionists could also attempt to advocate by conducting action research with transgender persons in the workplace (Bogdan & Knopp Biklen, 2007). Counselors, researchers, and interventionists advocating via action research could provide employers with information regarding workplace climate and performance, while offering potential solutions to remedy any issues that may be present in the workplace environment for transgender persons.

Implications for Future Research

We recommended that future researchers use qualitative, quantitative, and mixed methodologies to advance the knowledge base regarding the career development experiences of transgender persons. For example, future qualitative studies may allow researchers to explore other potential sources of discrimination and coping strategies with the transgender community. This could lead to the development of more comprehensive models and take into account diverse transgender persons, as well as MTF transgender persons. Second, the construction of objective-based assessment measures could facilitate quantitative-based studies that could lead to a better understanding of the career-related experiences of transgender persons. In particular, counseling and research professionals would benefit from understanding the degree to which specific forms of discrimination affect various aspects of the career development processes and the physical and psychological well-being of transgender persons. Finally, it is important to explore the effectiveness of career counseling and advocacy. There are currently no studies that have examined career counseling or advocacy processes and outcomes with transgender persons.

APPENDIX

Sample Semistructured Interview Questions and Probes

1. Describe your work experiences (or career path).

2. What challenges (and/or positive experiences), if any, have you faced in the workplace (or throughout your career path) due to your gender identity?

3. What types of discrimination, if any, have you experienced in your work (and/or throughout your career path)?

4. What type of experiences have you had as a result of being discriminated against?

5. How have you responded to the discrimination that you have faced?

6. What role does a career, occupation, or work play in your life?

7. How do you express your identified gender in the (workplace, school environment, home)?

8. How does your gender expression/gender identity affect you in your career and life?

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Franco Dispenza, Laurel B. Watson, and Greg Brack, Department of Counseling and Psychological Services, Georgia State University; T. Barry Chungy Department of Counseling and Applied Educational Psychology, Northeastern University. Correspondence concerning this article should be addressed to Franco Dispenza, Department of Counseling and Psychological Services, Georgia State University, FO Box 3980, Atlanta, GA 30302 (e-mail: FDispenzal@student.gsu.edu),
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Title Annotation:Research
Author:Dispenza, Franco; Warson, Laurel B.; Chung, Y. Barry; Brack, Greg
Publication:Career Development Quarterly
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Date:Mar 1, 2012
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