SALT LAKE CITY, July 9 (UPI) — Brigham Young University’s decision to stop providing gender-affirming services to transgender clients at its speech-language pathology clinic has sparked an accreditation review and debate about whether the decision was ethical.
The university, located in Provo, Utah, and operated by The Church of Jesus Christ of Latter-day Saints, discontinued services earlier this year. Transgender clients use voice training to make their voice reflect their gender identity.
According to C. Shane Reese, the university’s vice president of academics, BYU determined that service delivery did not comply with guidelines that tell church leaders to “advise against social transition.” The church describes social transition as including changing one’s dress or grooming or changing a name or pronouns to present oneself as other than one’s birth sex.
The master’s program in speech-language pathology is accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology, a semi-autonomous body of the American Speech-Language-Hearing Association. CCA launched an investigation in the spring to determine if the program remains up to standard for accreditation.
ASHA, a national professional and accrediting organization, says the end of gender-affirming services for transgender clients “is in direct opposition” to the expected practice of its members.
“ASHA recognizes gender-affirming voice and communication services for transgender and gender-diverse populations as part of speech-language pathology practice,” the association says in a statement posted on its website. “Transgender people who attempt to modify their voice without a trained speech therapist risk permanent damage to their vocal cords; and without appropriate services, there is an increased risk of related mental health issues.
The association alleges that clinic employees are being instructed “to act in a manner contrary to their responsibilities under the ASHA Code of Ethics.” He cites a section that says, “Individuals shall not discriminate in the provision of professional services or in the conduct of academic research and activities on the basis of race, ethnic origin, gender, gender identity/gender expression, sexual orientation, age, religion, national origin, disability, culture, language or dialect.
“As a result, BYU places its certified speech-language pathologists in an untenable position,” the statement read.
In its statement, ASHA also alleges that BYU’s decision is not in accordance with LDS Church policies and points to a section of the General Handbook of Faith that says members and nonmembers who identify as transgender people should be treated with “sensitivity, kindness, compassion and an abundance of Christ-like love.
ASHA is urging the university to reverse its decision and restore services for transgender clients.
BYU representatives did not respond to half a dozen calls and emails seeking comment.
Carri Jenkins, Assistant to the President for Academic Communications, issued a statement to the Salt Lake Tribune.
“While the Department of Communication Disorders no longer provides gender-affirming voice and communication services, it has reached out to the three students affected by this change to other providers,” the statement read. “BYU clinical staff have offered to help coordinate between students and these providers.”
Because it is church-owned, BYU enjoys religious exemptions under Title IX, a federal law that prohibits sex discrimination in schools. Title IX does not apply to an educational institution controlled by a religious organization where the application of the law would be inconsistent with its religious principles.
In a letter responding to ASHA’s statement, Reese said the university had made a “narrow, religiously mission-based decision” to stop providing gender-affirming services, but continued to ‘offer assistance with the other communication services it provides to everyone, regardless of gender identity or expression.
“ASHA does not require all clinics and clinicians to provide the full range of speech-language pathology and hearing services,” the letter states. “It prohibits a clinician from refusing services ‘based on an individual’s gender identity/gender expression that are not directly related to gender transition’.”
BYU students were not denied services unrelated to gender transition, such as treatment for post-stroke voice disorders and cognitive communication disorders, the letter said.
Additionally, Reese says he “respectfully disagrees” with ASHA’s assertion that the decision to discontinue some services is not in accordance with LDS Church guidelines.
He notes that the organization has cited only two parts of the relevant part of the manual. ASHA has not recognized provisions that directly address social transition, which include that church leaders must notify those making a social transition that they will experience certain church membership restrictions, says- he.
And Reese quotes this section from the Council on Academic Accreditation handbook:
“The accreditation process involves the evaluation of programs in light of their own mission, goals, and models of education – judging how well a program has achieved those goals and objectives. Therefore, the CAA does not explicitly prescribe the processes by which program results are to be achieved; rather, it assesses a program’s success in achieving results and objectives consistent with its stated mission (including religious mission, where applicable).
Support for service providers
A transgender client who had been at the BYU clinic for about a year and a half spoke to UPI on condition of anonymity. She said the voice therapy was very helpful.
“The whole time I was there, everyone was kind and supportive,” she said. “Everyone I interacted with directly was wonderful.”
The client said her voice caused her a lot of social anxiety and voice therapy was an important part of her transition.
“When I look one way and then open my mouth and sound another way, it can make people stare or feel uncomfortable around me,” she said. . “I will refrain from asking questions in class because I am afraid of drawing attention to myself. Just having more help to fit in better is a big deal.
The client said the therapy also helps ease the internal discomfort she feels “with my voice not sounding like what’s in my head.”
“It’s a bit of a pain,” she said. “It’s as if I had taken possession of someone else’s body. Sometimes it takes a second for my brain to register that it’s me speaking when I hear myself on a recording.
The shutdown of gender affirmation services was a blow, the client said.
“I haven’t gotten to the point yet where I’m able to use the voice I was working on in my daily life,” she said. “One of the big goals of the practice we were working on when it was canceled was to try to increase stamina, to make it my regular voice.”
When news of the cancellation spread, ASHA released its statement and the accreditation investigation began. A discussion on social media included accusations that the university’s action was discriminatory and transphobic. A poster replied in a tweet that gender affirmation services were not medically necessary and that the cancellation was not transphobic.
Speech-language pathologists in private practice in Utah offered to provide services to students, the client said. Additionally, the University of Utah in Salt Lake City and Rocky Mountain University, a private school in Provo, have agreed to provide student services at their clinics.
The customer receives the services of the Rocky Mountain program free of charge. The BYU clinic was also free.
“I didn’t feel like anyone was going to hear about it outside of the people directly affected, so I was really surprised at how supportive people were of me,” the client said. “It’s become this big deal.”
Knowing that people care about what happened makes her feel less alone, she said.
“You can feel really alone when you’re a queer student at BYU,” she said.
Key to success
Celia Hooper, who was a professor of clinical speech-language pathology at the University of North Carolina at Greensboro, said the services conflicted with ethical practices.
Speech therapy is an essential part of gender affirmation services because people often manage to look like the correct sex, but don’t look like it, Hooper told UPI.
“If you look like a woman but talk like a man, people think you’re a flirt and that’s not what you want to be,” she said. “Your communication skills, speech and language and non-verbal, you really are. I’ve had clients say, ‘It gave me back my soul.’ »
Hooper, who retired in 2020, worked with people transitioning from male to female starting in the late 1970s. Then most clients were over 30 and sneaking out the back door.
“They went through years of agony because it was so shameful to society,” Hooper said. “A lot of them worked on the change from male to female or female to male on their own or through a network of people who had been there. There was a real underground network.
Sometimes the steps they took to make the transition were ‘not so evidence-based’ and by the time clients arrived at a speech-language pathologist they had to kick a lot of habits, he said. she declared.
“Every new client, adults at least, comes in thinking, ‘All I have to do is raise my pitch and I’ll sound like a woman,'” Hooper said. communication is your pitch, your resonance, your choice of words. We try to raise the pitch of your voice slightly. You can do this, but you must be very careful not to create pathology, vocal nodule or hurt the voice someone. You have to know what you’re doing.