Hawaii Health Department Cautions Future Therapists About Documenting Conversations With LGBT Youth

"Be careful about what you document."
A Transgender Pride Flag is held above the crowd of LGBTQ+ activists during the Los Angeles LGBT Center's "Drag March LA: The March on Santa Monica Boulevard", in West Hollywood, California, on Easter Sunday April 9, 2023. - The march comes in response to more than 400 pieces of legislation targeting the LGBTQ+ community that government officials across the United States have proposed or passed in 2023. (Photo by ALLISON DINNER / AFP) (Photo by ALLISON DINNER/AFP via Getty Images)

Employees of the Hawaii Department of Health trained future therapists not to document their conversations with LGBT youth in order to hide the children’s sexual and gender identities from their parents, according to Fox News.

A May 5 training presentation by the state’s Department of Health employees made the recommendation to staff and graduate students at the University of Hawaii Center for Cognitive Behavior Therapy. The presentation was obtained by Fox News through a Freedom of Information Act (FOIA) request.

“Be careful about what you document – parents may be able to access the information,” the presentation said on a slide with the header, “Confidentiality.”

“It should ALWAYS be the LGBTQ+ person’s decision to whom and when they disclose their orientation or identity. Being LGBTQ+ is not a safety risk, but being out could be,” the same slide from the training added.

The training also told future therapists to “be aware of Hawaii’s age of consent for mental health services law for youth 14 and older.”

The training, titled “Affirming practice with LGBTQ+ youth,” was delivered by Kimberly Allen, who chairs the Health Department’s Child and Adolescent Mental Health Division’s Safe Spaces Committee, and Robin Lee, a member of the committee.

Allen said the warning to therapists not to document information about LGBT youth is meant to prevent “harm” to those youth from “outing” them to their parents.

“When we say, ‘Be careful about what you document,’ we convey that clinicians, when deciding what words to use in documentation, should carefully consider the youth’s individual situation and any harm that may arise from writing about a youth’s identity in the medical record,” she told Fox News in a statement through the state health department’s communications office.


“If a youth is not ‘Out’ to their parents but discloses their identity to their therapist, the therapist could inadvertently inform the parents if they document this information in the medical record and if the parent requests a copy of that record,” Allen said.

The training also cautions that some people may not have support from their family members or “religious leaders.”

“Realize that even though we live in a more liberal and affirming state, individuals’ experiences will be impacted by those around them who may be rejecting (family members, peers, school personnel, religious leaders, politicians),” the presentation says.

The presentation also tells trainees to consider their own “privilege.”

“How can you use your privilege to support others who are marginalized?” the presentation asks.

The training also had a section where “trans students explain why pronouns are important.”

Under “Prejudice” in the training were listed “heterosexism,” “cissexism,” “homophobia,” “transphobia,” “toxic masculinity,” and “micro-aggressions” including “micro-invalidations,” “micro-insults,” and “micro-assaults.”

“Minority stress” was also defined in the training as “additional stressors that people experience due to having a stigmatized minority status.”

In recent years, parental notification about children’s gender identity has become a hot-button issue, particularly in public schools.

More than 17,000 schools across the country have rules saying school staff can or should hide a student’s gender identity from parents, according to a list compiled by Parents Defending Education.

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