Affirming Transgender and Autistic Kids Tool Kit and BCBA CEU Course

Body autonomy remains a human right under attack via the legal and cultural climate within the United States. Receiving quality care has been a long standing struggle for people with historically marginalized identities. Most recently, transgender youth are facing a harrowing future. As of March 2025, the United States has introduced over 650 anti-transgender bills which directly impact trangender and gender diverse youth.

The State of Georgia passed a law banning most gender affirming care for transgender youth and in March 2024, the governor of Georgia passed a law prohibiting gender affirming medical care and hormone replacement therapy in people under the age of 18, claiming that “gender dysphoria is often comorbid with other mental health and developmental conditions, including autism spectrum disorder.” Thus weaponizing the co-occurrence of autistic people and transgender identities and furthering the struggle for autistic people to be viewed as full dimensional humans who experience the same range of gender and sexual experiences as their neurotypical counterparts. A gap is evident in current treatment considerations for the intersectionality of transgender identity and autistic identities  (Strang et al., 2014, Jansen et al., 2016, May et al., 2017, George et.al., 2017, Hisle-Gorman et al., 2019, Warrier et al., 2021). Hisle-Gorman et al., (2019) found that autistic adolescents were 4 times more likely to be gender-diverse (Hisle-Gorman et al., 2019). Compared to the 1-2% of the global population, 4.8% to 26% of people who sought gender diversity clinics had an autism diagnosis (Warrier et al., 2021). Current research points to disability staff attitudes towards LGBTQAI+ as influential factors to sex, sexuality, and sexual relationship education (Kelly et al., 2009). When autistic and LGBTQAI+ youth see medical providers they experience gender identity and sexual identity microaggressions (Sullivan et al., 2013). 

Paternalistic constraints of  intellectually disabled people including who they are and what they do is both state sanctioned through laws (Carney & Tait, 1998) and informally policed via social discourse (Yates et al., 2008). Families seeking support for their autistic children are often referred for applied behavior analysis (ABA) intervention. The field of ABA has long stressed parent training and coaching as a means to promote generalization of treatment gains for autistic children (Koegel, Schreibman, Britten, Burke, & O’Neill, 1982; Lovaas, Koegel, Simmons, & Long, 1973). This unique component has remained a critical component of intensive behavioral intervention (National Autism Center, 2015; National Research Council, 2001; Wong et al., 2015). In a little more than two decades, ABA has become an accepted health benefit covered by most insurance in the United States, a shift from previously being viewed as educational and excluded by most insurance providers (Kornack et al., 2023). Given the high co-occurrence of autistic persons also identifying with transgender identity, and the the likelihood of families of autistic persons referred for insurance funded ABA therapy, this provides board certified behavior analysts (BCBAs) with a unique opportunity to use parent training codes to build affirming and LGBTQAI+ inclusive advocacy behaviors into their parent training curriculums.

Among the successes parents have increased their understanding of minority stress and body dysphoria, and how their increased understanding positively affected their child. Parents were able to adjust their behaviors across three major areas: 1) identify implicit bias surrounding gender and disability within themselves, and determine how this has impacted their worldview and parenting 2) predetermine transphobic barriers across environments (school, medical facilities, government agencies) and 3) act as agents of change within their homes and community despite politically volatile climates. Transgender minors have reported increases in their overall feelings of worth and value as well as increased feelings of environmental affirmation despite added transphobic laws passed during the time of the study. Minors were able to achieve their self-identified goals across predetermined domains in the areas of self-help, social, communication, and safety awareness.

The Affirming Transgender and Autistic Kids Tool Kit has been created to meet the needs of behavior analysts working with autistic and transgender minors across politically, socially, legally and culturally volatile climates. The tool kit was created to provide behavior analysts with a framework for shaping parent behavior towards affirmation of their gender expansive child. The framework has been peer reviewed through PhD dissertation research with careful consultation from people with lived experience. The tool kit includes 68 downloadable resources including: common anti-transgender arguments and how to combat them, links to trusted mental health hotlines, resources to teach informed consent and advocacy for gender affirming medical care, links to journal articles, links to trusted gender affirming clothing and materials, tailored  assessment tools and surveys to measure affirming parental behavior and environments and the overall life satisfaction of the transgender minor created by the author of this course. Parent training slide decks and resources have been included for behavior analysts to help parents.

1) identify implicit bias surrounding gender and disability within themselves, and determine how this has impacted their worldview and parenting 2) predetermine transphobic barriers across environments (school, medical facilities, government agencies) and 3) act as change agents  within their homes and community despite politically volatile climates. The tool kit also includes assent and consent protocols which could be embedded into every aspect of learning and engagement as well as supportive tools and programming examples to help minors achieve their self-identified goals across predetermined domains in the areas of self-help, social, communication, and safety awareness. The tool kit, as a standard for best practice, can be used across ABA insurance authorizations, promotes inclusion of affirming the gender identity of a transgender child, and is designed to support the complex needs of an autistic learner.

Single enrollment: $900.00USD 

Group enrollment rates:

• Group of 2: $800.00/pp
• Group of 3: $700.00/pp
• Group of 4: $600.00/pp
• Group of 5+: $500.00/pp

Contact us about enrollment!
twiceconsultingservices@gmail.com

1)Welcome and Course Expectations:

Method:  Asynchronous  

Length: .5hr

1.  Participants will understand how to use the learning center and terms of use for the course 
2. Participants will understand how to ethically and appropriate use the materials and course content in their practices 
3. BACB Ethics code: 5.05 Use of Intellectual Property (see 1.01, 1.02, 1.03)

2) Affirmation Foundation:

Method:  Asynchronous 

Length: 1hr

1.     Discuss diversity, equity and inclusion terms & definitions which impact a client’s experience with a disability professional 
2.     Introduction to anti-transgender legal, political, and cultural climate
3.     Access trusted resources when working with LGBTQIA+ clients. 

3) Implicit bias and Disability Professionals:

Method: Live 

Length: 1.5hr

1.     Engage in the My Trusted 10 self-assessment to further conceptualize the learner’s blind spots towards the LGBTQIA+ community as a behavior analyst.
2.     Define and differentiate between inequity, equity and justice. 
3.     Apply the equity lens to disability practice modalities
4.     Self-assess implicit bias of the LGTBTQAI+ community 

4) Minority Stress and Racial Battle Fatigue

Method: Asynchronous 

Length: 1hr  

1. Participants will learn about racial battle fatigue and minority stress
2. Participants will be able to identify mind traps and determine how to reframe these thoughts
3. Participants will learn about key protective factors for LGBTQAI_+ youth    

5) Gender Dysphoria and Gender Euphoria

Method: Live 

Length: 1.5hr

1. Participants will learn about gender dysphoria and gender euphoria 
2. Participants will learn what rainbow capitalism and how to contextually apply their support of large vs small corporations 
3. Participants will learn strategies to support reductions in gender dysphoria and ways to support increases in gender euphoria

6) Public Health & Trauma Informed Violence Prevention Practices: Dr. Gemma Skuraton

Method: Asynchronous 

Length: 1hr 

1. Participants will conceptualize the application of social determinants of health 
2. Participants will conceptualize violence trauma informed violence prevention strategies 

7) Gender Affirming Assessments and Goal Writing

Method: Live 

Length: 2hrs  

1. Participants will learn how to differentiate referral behaviors
2. Participants will learn how to incorporate gender diversity considerations into their assessments and learn how to use gender affirming assessment tools 
3. Participants will learn how to conduct gender affirming preference assessments
4. Participants will learn how to incorporate intersectional considerations within treatment planning

8) Lived Experience Panel

Method: Live 

Length: 1hr

1. Participants will consult with gender and ND adults from the lens of their lived experience 
2. Participants will maintain competence by obtaining lived experience consultation  
3. Participants will be able to list ways they can involve their learners as equal members of their stakeholder team

9) Writing Gender Affirming BIPs and Parent Training

Method: Live 

Length: 2hr

1. Participants will learn how to write gender affirming treatment plans: BIPs and Goals
2. Participants will explore the parent training curriculum
3. Participants will learn how to make gender affirming environment recommendations 
4. Participants will learn how to combat common anti-transgender arguments and get parental buy-in

10) Next Steps

Method: Asynchronous 

Length: .5hr

1. Participants will take the A Self-Assessment Tool for Cultivating Affirming Practices With Transgender and Gender-Nonconforming (TGNC) Clients, Supervisees, Students, and Colleagues
2. Participants will access a lived experience consultation list

Dr. Gabriella Barrientos is the co-owner of Twice Consulting Services (TCS) LLC and Chief Clinical Officer for Twice Affirming Behavioral Services LLC, which provides consultation and mentorship for affirming behavior analytic services for clients meeting the intersection of LGBTQAI+ and autism with a focus on developing practitioners in parent coaching to increase supportive and affirming parenting strategies. Dr. Barrientos is a licensed, international, and board-certified behavior analyst. She is also a Certified Diversity Executive (CDE) and professional DEI consultant for large and small organizations. She has experience in early intervention, intensive behavior intervention, adaptive skills training, school services, adult group home intervention, vocational skills training, as well as parent and family training. Dr. Barrientos’s practice values center on the affirmation of transgender youth, and intersectionality. She advocates and fosters diversity, equity, and inclusion of historically marginalized and underrepresented populations. Her work, particularly with minors and disabled populations, is client centered and relies on trauma informed, assent and consent practice to prevent abuse. Dr. Barrientos is a graduate from the school of Social Work & Social Science with Queen’s University in Belfast, one of the United Kingdom’s Ivy League schools and member of the Elite Russell Group where she is engaged in groundbreaking, primary research to support clinical recommendations for transgender and autistic youth resulting in the evidenced based tool kit available through this CE training.

Dr. Gemma Skuraton (pronouns: she/her) is the co-owner of Twice Consulting Services (TCS), Vice President of Public Health Strageies and Director of Student Wellness & Health Promotion for a mid-size institution in the southeast where she oversees the public health prevention office including reproductive health, mental health, interpersonal violence and harm reduction strategies for substance misuse, overdose prevention and chairs the university sexual assault response team. Dr. Skuraton  is a Certified Diversity Executive (CDE), Certified Diversity Professional (CDP) and completed a postdoctoral Diversity Equity and Inclusion Fellowship. Dr. Skuraton holds a Doctorate and a Masters degree in Public Health with an emphasis in Community Health Behavior and Education. Dr. Skuraton is a community-based participatory researcher primarily centered around designing, implementing and evaluating inclusive health & wellness co-curricula. Advancing the tenets of reproductive justice is a passion area for Dr. Skuraton and is an expert in gendered violence prevention. She is the creator of the Period Equity Movement, a gender equity campaign and grassroots initiative which was awarded two international awards. The campaign was recognized for advancing reproductive justice by addressing period poverty and creating safe and affirming environments for transgender, gender non-conforming and non-binary college students living in rural Georgia. Dr. Skuraton is the creator of the LGBTQIA+ Inclusive Fitness Professional Course; the first professional ethics course that bridges wellness, health education, gender and relationship affirming practices for certified wellness professionals.

This tool kit is intended to for two main purposes: 1) recommendations for sustainable, affirming and practical considerations for the transgender community across politically volatile climates and 2) to serve as necessary restorative justice and reparations to the transgender and autistic community as for the role Applied Behavior Analysis (ABA) played in the original creation of conversion therapy.

The author recognizes the traditional prescription of ABA practices through a racist, binary, homophobic, transphobic, and ableist lens. This tool kit, and recommended practices, have been developed by listening to, and learning from, the lived experiences of Transgender and Autistic Self-Advocates. Practitioners are invited to work as agents of change, advocacy, and autistic/LGBTQAI+ empowerment.