Upholding Inclusive Practices in Speech-Language Pathology and Audiology

Upholding inclusive speech-language pathology and audiology practices is critical!

In the fall of 2023, members of L’GASP, the Multicultural Issues Board, and the ASHA State Affairs Team came together to record a lecture to inform and empower CSAP members with information regarding the legislative landscape surrounding gender-affirming care and advocacy for transgender and gender expansive clients, students, and professionals within the discipline of Communication Science and Disorders.  A recording of that lecture is available here.  This current piece provides a review of some of the information presented and links to resources that state leaders can use to stay informed regarding the legislative landscape and advocacy efforts in this area. 

What is the problem?

During the 2023 and 2024 legislative sessions, the United States has seen an excess of anti-LGBTQ+ policies. Part of the purpose of these policies is to instill fear and empower discrimination against LGBTQ+ individuals and their allies both within and outside our profession. Additionally, we’ve seen a wave of anti-DEI (diversity, equity, and inclusion) policies in addition to the recent anti-affirmative action ruling of the Supreme Court. These anti-DEI policies threaten our urgent need to diversify the profession in both educational practices and representation. 

What can state leaders do? 

Leadership in our profession holds a unique responsibility to model the professional support we hope to see in other organizations. 

State leaders may be among the first to be contacted by providers in their state with questions regarding the provision of gender-affirming care. It is important that state leaders have the information and resources to clearly communicate the current status regarding gender-affirming care in their state. The authors of the fall presentation on this topic suggest the following to help your members avoid discrimination against LGBTQIA+ individuals and navigate the current legislative climate. 

• Use ASHA resources to find information for yourself and your state regarding best practice to avoid discrimination. For instance, leaders should be familiar with the ASHA Code of Ethics, which  specifies that ASHA members must not discriminate in professional service delivery to individuals on the basis of gender, gender expression, gender identity, sex, sexual orientation, etc.   

• Clearly communicate with the profession that we oppose anti-LGBTQ+ and anti-DEI policies and encourage their lobbyists to oppose these policies. 

• Stay informed regarding anti-LGBTQ+ and anti-DEI policies affecting their states and understand the terminology definitions that may intersect with our profession (e.g., definition of the term ‘clinician’). 

• When legal questions arise regarding gender-affirming care from their membership, quickly respond with current information or direct them to their appropriate ASHA State Affairs Team representative for information. 

• Continue to model affirming care and develop strategies and resources for clinicians to navigate anti-affirming policies at state or local levels.

What can universities do?

Universities should continue to honor the CAA (Council on Academic Accreditation) Standards 1.8 (anti-discrimination standard) and 3.4 (DEI standard), which respectively require programs to have anti-discrimination policies and DEI topics infused into the curriculum. University admission committees should use holistic admission policies that allow admission of diverse student bodies that would better reflect the client populations we serve. Our programs are responsible for upholding the standards set forth by the discipline and reviewed by the CAA. 

What can clinicians do?

As a profession, it is vital that we feel empowered to operate at the highest ethical and professional standards of our discipline. Gender-affirming care has been restricted in several states, causing fear of the legality of certain services. However, these restrictions are mostly targeting access to hormone and/or surgical care, both outside our scope of practice. As stated above, ASHA members can and are ethically required by the ASHA Code of Ethics to provide care without discrimination. Therefore, clinicians should continue to provide their services regardless of their clients’ gender and sexuality. 

• If you are concerned about the legality of certain services, please check this resource regarding state mandates regarding diversity, equity, and inclusion.  

• Also, consider emailing your ASHA State Affairs Team: midwestern states (Doanne Ward-Williams – dwardwilliams@asha.org), northeastern states (Susan Adams– sadams@asha.org ), southern states (Tim Boyd– tboyd@asha.org ), and western states (Eileen Crowe – ecrowe@asha.org). 

• Finally, if restrictions create barriers to your affirming and responsive care, be creative in how you affirm your clients, students, and patients.  

What can everyone do?

Allies need to be loud and proud! When anti-LGBTQ+ and anti-DEI bills show up in our legislative sessions, we must speak out against these harmful practices. Phone calls and emails to our local officials are necessary to oppose these bills. Hold yourself and other professionals accountable for being informed and operating at our highest ethical and professional standards. Report discrimination of both University Programs (to the CAA) and professionals (to ASHA). Despite the barriers infiltrating our systems, we can continue to provide affirming and ethical care with pride. 

Below is a QR code where you can access a variety of resources to assist you in your advocacy efforts.  A legislative tracking tool developed by the ASHA Office of State Affairs is included. 

Source: Fairchild, M., Lenell, C., Robinson, G., Jordan, A., Ward-Williams, D., Mundhe, A., Gregory-Martin, K., (2023). Upholding Inclusive Practices: Challenges and Strategies for Gender Affirming Care in Speech-Language Pathology and Audiology, Recorded Seminar, Council of State Association Presidents (CSAP), Boston, MA

Article Authors:

Charlie Lenell, PhD, CCC-SLP (they/them)

Marilyn Fairchild, MA, MA, CCC-SLP (she/her)

Kyomi Gregory-Martin, Ph.D., CCC-SLP (she/her) 

Phillip Hernandez, Ed.D., CCC-SLP, BCS-CL (he/him)

Gregory Robinson, Ph.D., CCC-SLP (they/them)

Anushree Mundhe, MS., CCC-SLP, CBIS (she/her)