Massachusetts has a sudden secret policy for rejecting sex marker changes for trans minors

As anyone who is paying attention should know, trans folks are being urged to get all of their paperwork correct and matching before the incoming administration. However, families I work with are having one hell of a time getting amended birth certificates for trans minors in Massachusetts. 

Here is the information on how to request an amendment to a birth certificate, from the Registry of Vital Records and Statistics. The website states "A parent or guardian must complete this form if the record change is for a minor."

The affidavit itself is here.

Screenshot of part of the affidavit, showing one line for signature of parent/guardian

Note that it has one line for the signature of one parent/guardian, and it requests the name and signature of parent/guardian in the singular.

The relevant Massachusetts General Law is here, and states:

(1) A person who is 18 years of age or older, an emancipated minor or the parent or guardian of a person who is a minor may request a change in the sex designation on the person’s birth record to a sex designation including, but not limited to, “female”, “male” or “X”. An “X” designation may indicate that the person is another gender or an undesignated gender. A request for a change in the sex designation on a birth record shall be accompanied by an affidavit executed under the penalty of perjury by the person to whom the record relates or by the parent or guardian of the person if the person is a minor attesting that the request is to conform the person’s birth record to the person’s gender identity and is not made for any fraudulent purpose. No medical or healthcare related documentation, court order or proof of change of name shall be required by a town clerk or other official in connection with a request under this paragraph.

Nowhere, anywhere, does any of this state that both parents must sign the affidavit if the minor has two legal parents. For the record, I don't care if they did require that if it were how the law were passed; it actually makes sense. However, they don't state anywhere that it is required, or even suggested, and it appears to have been done suddenly, and secretly, and really appears to coincide with the recent passage of the law that allows amendment without requiring any medical documentation.

So what is happening in practice is that the Registry of Vital Records and Statistics is rejecting these affidavits and sending a letter stating the form must be signed by both parents. When the law is cited to the amendments supervisor, the supervisor states that yes, the law only requires one signature, but the Registry of Vital Records and Statistics legal department has decided to have a policy that requires both signatures. Also, they don't post their policies on their website, and instead just reject amendments from parents of trans kids.

Oh, and the Registry of Vital Records and Statistics will not allow the form to be resubmitted by e-mail, and will not pay for printing or postage for the resubmission. They are in the process of redoing their form, but for now, they expect families to be psychic and know that they need to provide something that is listed nowhere on their documents. I attempted to correspond with a supervisor there, who wouldn't acknowledge that this is a sudden secret policy that is not stated anywhere whatsoever:

Screenshot of e-mail from Christina Bocolos, Amendments Supervisor, stating, "I do recognize in the law it says one parent but policy request both parents. Is there a reason why the other parent cannot sign?"

Screenshot of e-mail from Christina Bocolos, Amendments Supervisor, stating, "With any amendment for children, we ask for both parents to sign off on an amendment. Our policies are not always posted on our website. The form was designed to go with the law but after further discussions with legal on the need for the second signature, we are getting the form changed to ask for both parents to sign. I understand the inconvenience, but this is what is required for the amendment."

I cannot post the other e-mails as they contain private information about people, but the supervisor states they do not pay for printing or postage and states that many forms are filled out "incorrectly" and have to be redone. 

I have had a lot of jobs in public health and state-contracted agencies, though none employed directly by the state. At all of these, if I failed to get something signed or filled out correctly because I did not adequately explain the policy to a family, I would be required to travel to the family immediately and get the form correctly filled out and signed. I would absolutely not be required to make a family pay for printing and postage due to my own error. What is with these state agencies just being allowed to do whatever they want? It's already ridiculous that it costs $82 for a correct birth certificate for a trans child to be safe, with no provision for a reduced fee for families receiving public assistance. The supervisor with whom I corresponded did not address any of this, just repeatedly stating that this was their policy, and also repeatedly referring to forms "that were not filled out correctly."

I cannot find anything addressing this in the guidance about changing documents from Massachusetts Transgender Political Coalition, Fenway Health, GLAD, or any other sources. I would urge all of these folks to publicize this widely so that no one else receives rejections and is unable to get their birth certificate before the inauguration. 

UPDATE 

December 17 11:39am: After posting this on social media, I have been contacted by a few attorneys with organizations specializing in public policy and discrimination issues. They have verified that they also believe I am interpreting the law correctly, and that they believe it is illegal for a state agency to have a policy that goes beyond the law. Advocacy is underway, though anyone who has additional expertise or suggestions is very much welcome to contact me as well and I can get you connected with the group of us working on this. 

December 19 2:27pm: We have some legislators meeting with DPH. Fenway and MTPC are updating their information to let people know this is happening so they can make an informed decision whether to comply with being asked for information beyond what the law requires in order to not risk having their amendment rejected. 

NCTSN has a number of free NBCC/LMHC CEUs

It requires creation of an account to see very much, but there are dozens of self-study free CEUs at their website here. Reminder that for Massachusetts LMHCs, we can obtain up to half (15) of our CEUs via asynchronous methods; at least 15 are required to be live online or live in-person trainings.

EDIT 11/01/24: I did one on working with young children in the foster care system. It was pretty awful -- completely lacking in any competence regarding the biases of the system, provided a case example with absolutely no mention of culture, referred to parents of a reunifying child as "birth parents," and was clearly not remotely informed by formerly adopted or fostered adults. It was also based on a model in which a local CPS agency had contracted with an agency to provide highly qualified clinicians for all of a family's visitation and extensive therapeutic work with child/family and foster providers. Which, great, but not applicable to nearly all families involved in the system who don't have such a thing available. I'm going to try one of the trainings that isn't CPS-specific and see if it is any better. 

Disclaimer: My only affiliation with this organization is having served on a regional advisory board of theirs in the past that had nothing to do with CEUs. I post free/low-cost LMHC CEUs when I come across them, as one of many efforts to decolonize mental health practice.

Free and low-cost online subclinical services for minors

I have begun creating this directory. Please feel free to add more resources, and please share in relevant spaces. 

From the intro: This is intended to be a listing of affordable online subclinical services serving those under 18. The intention here is to provide resources for families whose child's needs are not currently at the level of requiring medical therapies (or who have financial difficulty in accessing these), but are higher than requiring no formal support. 

Resources should focus on those provided by folks with professional degrees or connection to a mainstream clinical or social services organization, as the intention here is that families are able to assure schools and pediatricians that their child is receiving appropriate services. 

While the owner of this resource places high value on lived experience and community-based healing over "evidence-based practices,"* resources here should be free of blatant pseudoscientific approaches and must be trauma-informed, antiracist, queer/transgender-inclusive, neurodiversity-affirming, disability-positive, fat-positive, and so forth. Religious resources may be included, provided they are truly inclusive, including of those who express skepticism toward their faith background or may be looking to leave it. No ABA providers may be included, unless they publicly and consistently identify as someone who has left the field due to its problematic nature. 

*Research is important, and I constantly seek it out and cite it – or cite that no research has been done that adequately takes into account the intersections at play in the situation at hand. The majority of research, particularly that which is used in recommending and funding treatment approaches, reflects ableism and cultural bias. We absolutely should be looking at well-designed studies that are done or advised by people of the same demographics as those being studied. "Evidence-based practice" literature usually isn't this. 

Financial disclosure: One of my own LGBTQ+/neurodivergent youth spaces is included. I do make money off of this, though you can see based on the prices that this was not my primary goal in creating the space. 

Can we add a little nuance to the discussions of trans kids who aren't out to their parents?

Let me start by saying that of course kids (cis, trans, unsure, and so forth) should all have the freedom to use a name in any space and ask that this not be shared with their parents.

What I am tired of seeing is the rhetoric from well-meaning queer folks and allies of "if your kid is only out at school, this means they feel unsafe telling you they are trans, so you have failed as a parent."

As someone who has worked with literally thousands of trans and gender-expansive kids, this just doesn't follow. Yes, sometimes I have kids tell me their parents are transphobic and would react in unsupportive ways. This is a real thing that happens, and which we need to be aware of and be prepared to address.

What happens much more frequently is that kids tell me they know their parents are supportive of trans folks in general, their parents often even are queer/trans themselves, and the issue isn't about transphobic parents, but just that they are wanting to experiment and practice experiencing how less-important people respond to a new name/gender before they are ready to share with the most-important people in their lives.

I don't want to 100% liken someone's gender identity or expression to a hobby, as we often have hobbies that we pick up and quickly discard, and I don't want to feed into the transphobic "it's a phase; they'll get over it" rhetoric. However, I do think we need to make less of a big deal overall with people exploring gender. It's completely normalized for cis children to try on different names and forms of self-expression, especially during early adolescence. Why should it be extremely different for a cis middle-schooler to take on a goth expression and ask to be called Raven or Onyx than for another middle-schooler exploring identity to include a name and pronouns that differ from their birth sex? So along these lines, do people assume that a child has horrible abusive parents if they aren't planning on mentioning just yet that they wear black lipstick at school and have their friends call them Onyx? Probably not. Does this suddenly change if Onyx uses pronouns that differ from the ones their parents know? It shouldn't. For many adolescents, it's just easier to try something on with people who are less close and whose opinions matter less. It might be easier to have kids in the cafeteria tell you something doesn't really work for you than to observe and process your parents' reaction.

Let's focus more on allowing young people to live in the here and now. If they want to be called a particular name and use particular pronouns for any reason, that should always just be their choice. It doesn't need to involve parental permission, it doesn't need to be likened to any sort of "concern" or mental health issue that their parents need to be informed about, and it doesn't need to be a big deal. Let's just let people be called what they want, regardless of the reason. 

More free Zoom LMHC CEUs

I was actually looking for free yoga classes, and found that there are hundreds of them on eventbrite (set location to "online," set price to only free offerings). My family and I have done a few classes and have found them to be pretty solid. Many of the classes are one-time offerings from healthcare organizations and community centers. Some are organizations that look a bit culty, but I'm able to look past that for a free class where I can log right off at the end and don't have to engage in small talk.

One of the yoga classes I found was for professionals, and mentioned CEUs. I assumed that they would be CEUs for one of the professions that doesn't require formal approval, but was surprised to see that the organization offers NAADAC CEUs, which is an NBCC-approved provider. The organization is Aliya Academy, and they have a number of different free trainings offering 1 CEU each. Most of them are focused on those who have substance use disorders, as this is the organization's mission. 

If you've read my blog before, you know my feeling about CEUs: There is nothing in place to assess whether clinicians are actually engaging in relevant learning and applying it to our work. CEU credits do not accomplish this goal. Those of us who are committed to practicing ethically and effectively are constantly engaged in learning through keeping up on research and listening to experiences of marginalized people, and our participation in formal CEU courses is pretty immaterial. CEUs are just a formality we must go through, most of the available courses are massively overpriced yet contain outdated and disturbingly biased content, so we might as well go with free CEUs of potentially questionable quality. I personally get my actual continuing education by reading and watching content from autistic and other disabled folks, former foster youth, systems-involved parents, people affected by carceral systems, and so forth. I get my CEU credits by attending Zoom workshops that explain what ADHD or depression is –– usually badly, with a white-middle class bias, and with no content from folks with the conditions –– and wonder how there are licensed clinicians who do not already know this material.

William James College is also hosting a free Zoom CEU workshop on stalking behavior in autistic folks. It doesn't appear to have any content from actual autistic folks, so I'm skeptical, but it's free. It's worth signing up for their CEU e-mails, as they frequently have free ones. A few have actually been quite good and have been largely based on lived experience, while others have been typically poor-quality CEUs of things that people should already know. 

[Usual disclaimer that I am not affiliated with these organizations. I have no experience with Aliya Academy and minimal experience with WJC. I am not specifically endorsing the trainings. I post free and low-cost CEUs I encounter for the reasons stated above.]

White autistic people engaging in racist behavior aren't doing this "because they're autistic"

I keep seeing posts from white non-disabled clinicians about some variation of "a neurodivergent child used slurs, got punished, and punishment for something they don't understand is wrong."

The posts usually focus on how punishment isn't effective (true, in general), consequences for not exhibiting a skill someone really doesn't have are pointless and demeaning (yep), but basically ending there (hmmm...). There is no talk about impact vs. intent, or why the child doesn't have the skill to understand the impact of slurs.

Well, there is discussion about why the child doesn't understand not to use slurs, except the posts and ensuing comments always tend to say that the child doesn't understand the impact of slurs because they are autistic or otherwise neurodivergent.

Wow. OK, if this were true, then Black and brown autistic folks would be going around using slurs and having no idea what they mean. As someone who is frequently around many Black and brown autistic adults and youths, I can tell you that this isn't occurring.

White autistic people who are engaging in racist behavior are not doing this "because they are autistic." They are doing this because of white privilege. 

[Image description: Photo of a Black toddler or preschooler in tattered overalls in a field next to a photo of a white toddler or preschooler in a KKK robe in front of a group of adults in KKK robes. Text reads "If the child on the left was old enough to pick cotton and the child on the right was old enough to attend Klan rallies, then today's children are old enough to learn about both of these and how they've led us to where we are today." The instagram account AfricanArchives is credited.] 

The reason that a number of white autistic youth are using slurs with no idea of their impact is because of white privilege, not because they are autistic. And sure, non-autistic white youth may be quicker to intuitively pick up on the meaning and impact of slurs than autistic white youth. But the overall dynamic is still due to white privilege, not that they are autistic. Black children experience racism, thus have to talk about it, much earlier than white children are typically taught about it. 

Black or brown autistic children (with sufficient verbal or spelled language) are no different in this regard. Their families are talking about racism essentially from the time they are born. They know the impact of slurs, because their families are talking about themselves or people in their communities being on the receiving end of these. Black children of all neurotypes are given The Talk starting at an early age, in which they are taught the importance of things such as always getting a receipt and not touching things in stores. Particularly given the rates at which Black and Latine autistic people are undiagnosed, parents aren't holding off on discussing these things with autistic children -- they often don't officially know they have autistic children! In my experience, Black and brown parents who notice that their children struggle with impulse control or language (with a diagnosis or not) are particularly focused on working with their children on being cautious about what they say to whom and how they say it -- because they have to, for safety reasons. 

Similarly, parents of white children who notice they may have differences in how they pick up on and use social information need to be particularly focused on educating their children from an early age as to the meaning and impact of slurs, along with other anti-racism skills such as recognizing microaggressions and responding to these. All parents of white children should be teaching their children to be anti-racist from birth, and autistic or otherwise neurodivergent children may not intuitively pick up on all of this teaching and may need to have the meanings of slurs spelled out. Rote rules around slurs are actually easier to teach than a lot of universal social skills*:

• these words are violent and hurt people
• white people may never use them
• any white person using them is committing a harmful act
• they might occur in media, and the choice to include them is a separate discussion
• if you are reading from a text or quoting something and are white, you need to use the censored forms of them

This is probably one of the easiest social skills among those we teach, honestly. There isn't a lot of nuance. If a parent has neglected to teach their white child about slurs, there should be some reflection here. It isn't because it's a hard topic to teach in an education sense; there is clearly something going on where the parent hasn't fully accepted that it is their role as parents of white children to actively teach their children how not to perpetuate racism. 

Finally, low expectations are a form of ableism. We really don't want to perpetuate "they don't know any better because they're autistic," especially around a dynamic where this is objectively not the case. Autistic folks typically have a strong sense of social justice. If they are raised in a way that includes all different perspectives and teaches them about the existence of different types of oppression, they are typically amazing allies for marginalized groups to which they do not belong.

*Universal social skills are the skills that all people of all neurotypes need to learn (consent, boundaries, self-advocacy, negotiation, etc.), which is distinguished from the flawed idea of teaching autistic people "social skills" that really mean to engage in masking or changing their behavior to appear neurotypical with no real functional benefit. 

Free online DC 0-5 training with 16 MA LMHC/LICSW/NBCC/NASW CEUs

For Massachusetts providers only. Get half of your biannual CEU requirement completed for free. It's this October, which is unfortunate for those of us who already have 2022-2023 completed, but fortunate for those who have waited until the last minute. (Or social workers; I think y'all renew in even years?)

I've taken the training in the past and it's actually quite good. I definitely encourage people to sign up if you can, especially if just to let folks know there is demand for online/accessible options for these types of trainings. 

Information here.

[Usual disclaimer that I have no affiliation with this training or organization and just am passing along free/low-cost CEUs.]