- A
- Foundations and Basic Commitments
File: AC-E4 (pdf)
May 10, 2016
CONFIDENTIAL
GENDER TRANSITION PLAN
The document supports the necessary planning for a student’s formal transition of gender from its commonly assumed status to something else. Its purpose is to create the most favorable conditions for a successful experience, and to identify the specific actions that will be taken by the student, school, family, or other support providers.
School: ________________________________________
Today’s Date:____________________
Student’s Preferred Name: ___________________________________________
Legal Name: ______________________________________________________
Student’s Gender: ___________________
Assigned Sex at Birth: ________________
Student Grade Level: _________________
Date of Birth:________________________
Sibling(s)/Grade(s):
___________________________________(_____)/
___________________________________(_____)/
___________________________________(_____)/
___________________________________(_____)/
___________________________________(_____)
Parent(s)/Guardian(s)/Relation to Student:
_________________________(_________________________)/
_________________________(_________________________)/
_________________________(_________________________)/
_________________________(_________________________)
What is the nature of the student’s transition (male-to-female, female-to-male, a shift in gender expression, etc.) ___________________________________________________________________________
PARENT GUARDIAN INVOLVEMENT
Are guardian(s) of this student supportive of their child’s gender status? ____Yes ____No
If not, what considerations must be accounted for in implementing this plan? ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
INITIAL PLANNING MEETING
When will the initial planning meeting take place? _____________________________________________________________________________
Where will it occur? _____________________________________________________________________________
Who will be the member of the team supporting the student’s transition?
- Student_________________________________________________________________
- Parent(s)_______________________________________________________________
- School Staff ____________________________________________________________
- Other___________________________________________________________________
STUDENT TRANSITION DETAILS
What specific information that will be conveyed to other students (be specific)? ____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
What requests will be made? ____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
With whom and when will this information be shared?
- With peers in the transitioning student’s class only
Date:____________________________________ - With peers in the student’s grade level
Date: ____________________________________ - With some/all students at school (specify)_______________________________
Date: ____________________________________ - Other (specify)_____________________________________________________
Date: ____________________________________
Who will lead the lessons/activities framing the student’s announcement? _____________________________________________________________________________
_____________________________________________________________________________
What will the lesson/activities be? _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Will the student be present for the lesson/sharing of info about the transition? _____Y _____N
If yes, what if any role does the student want to play in the process? _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Once the information is shared, what parameters/expectations will be set regarding approaching the student? _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Other notes, considerations, or questions: _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
KEY DECISIONS PRIOR TO STUDENT’S TRANSITION
Communications with Other Families
Will any sort of information be shared with other families about the student's transition? ______________________________________________________________________________
______________________________________________________________________________
With whom: _____Families in child's grade _____Whole School _____Other (specify) ______________________________________________________________________________
Who will be responsible for creating this? ______________________________________________________________________________
When will it be sent? ______________________________________________________________________________
How will it be distributed? ______________________________________________________________________________
What specific information will be shared*? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions/Notes: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
* see sample letters
Training for School Staff
Will there be specific training about this student's transition with school staff?
_____Y _____N When? _______________________________________________
Who will be conducting the training? What will be the content of the training? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions/Notes: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Parent Information Night about Gender Diversity
Will there be specific training for school community member? _____Y _____N
When? ________________________________________________________________________
Who will conduct it? Will it reference the student's transition? What will be the content of the training? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions/Notes: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Class Meeting with Parents
Will there be any meeting with the families of the transitioning student's peers? When? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Who will lead the meeting? Who will be attending the meeting? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What will be the purpose for this meeting? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Identifying and Enlisting Parent Allies
Are there any parents/adults in the community you would like to enlist in support of the child's-transition? If so, who? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
When will you speak with them? What will be your request? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions/Notes: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Identifying and Enlisting Peer Allies
Are there other students you would like to enlist in support of the child's transition? If so, who? ______________________________________________________________________________
______________________________________________________________________________
When will they be spoken with? What requests will be made? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions/Notes: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Siblings
Does the student have any siblings at the school? What needs to be considered for them? ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Training in their classroom (s)? ______________________________________________________________________________
______________________________________________________________________________
Emotional Support? ______________________________________________________________________________
______________________________________________________________________________
Questions/Notes:________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
TIMELINE
Which of the following will take place in relation to this student's gender transition, and when will it occur and who will be responsible for making it happen?
| ✔ | Activity | Date | Lead |
|---|---|---|---|
| Initial planning meeting | |||
| Lessons / activities with other students | |||
| Communications with other families | |||
| Training for school staff | |||
| Parent information night about gender diversity | |||
| Class meeting with parents | |||
| Identifying and enlisting parent allies | |||
| Identifying and enlisting peer allies |
What are the specific follow-ups or action items emerging from this meeting and who is responsible for them?
| Action Item | Who? | When? |
|---|---|---|
Date / Time of next meeting or check in
______________________________________________________________________________
Location
______________________________________________________________________________
Exhibit:
End of File: