ASHA Statement on Brigham Young University Administration Decision to Deny Speech Services for Transgender Clients

February 11, 2022

The decision by the Brigham Young University (BYU) administration to require their Department of Communication Disorders to end all voice and communication services at its Speech and Language Clinic for transgender clients is in direct opposition to practice expected of ASHA members and contrary to the ASHA Code of Ethics (2016).

ASHA recognizes gender affirming voice and communication services for transgender and gender diverse populations within the speech-language pathology scope of practice. ASHA members provide vital clinical services to gender diverse populations who may have voice or other speech-language disorders unrelated to their gender, as well as services to individuals whose voices do not reflect their gender. Transgender individuals who attempt to modify their voice without a trained speech-language pathologist, risk permanent damage to their vocal cords; and without appropriate services are an increased risk for related mental health challenges. Ensuring treatment for all individuals in need of speech, language, hearing, and related services—including transgender individuals—is consistent with ASHA’s Code of Ethics.

Principle I, Rule C of the ASHA Code of Ethics states the following: “Individuals shall not discriminate in the delivery of professional services or in the conduct of research and scholarly activities on the basis of race, ethnicity, sex, gender identity/gender expression, sexual orientation, age, religion, national origin, disability, culture, language or dialect.” Therefore, BYU is putting its certified speech-language pathologists (CCC-SLPs) in an untenable position. These employees are now being directed to act in a manner contrary to their responsibilities under the ASHA Code of Ethics.

ASHA strongly believes the principles set forth in the Code of Ethics, including Principle I, Rule C, are considered essential to the practice of speech-language pathology. BYU’s decision can in no way be supported or justified by the ASHA Code of Ethics.

There are areas of concern to be addressed. For the university to take such action, the transgender clients’ protected health information would have been provided to the BYU Administration, which is a violation of the HIPAA Privacy Rule. The Rule requires appropriate safeguards to protect the privacy of protected health information and sets limits and conditions on the uses and disclosures that may be made of such information without an individual’s authorization.

BYU’s decision does not align with The Church of Jesus Christ of Latter-day Saints’ policies and guidelines. According to section 38.6.23 of the General Handbook: Serving in The Church of Jesus Christ of Latter-day Saints, “transgender individuals face complex challenges. Members and nonmembers who identify as transgender—and their family and friends—should be treated with sensitivity, kindness, compassion, and an abundance of Christlike love.”

Moreover, the General Handbook acknowledges and provides latitude for other forms of medical care to be provided to transgender individuals. Section 38.6.23 of the General Handbook states, “some children, youth, and adults are prescribed hormone therapy by a licensed medical professional to ease gender dysphoria or reduce suicidal thoughts.” It is incongruous that voice and communication services would be singled out for elimination, especially with the positive impact of gender affirming practices.

The master's MS education program in speech-language pathology at Brigham Young University is accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). The CAA’s accreditation standards require academic programs provide content and opportunities for students to learn to practice in a manner consistent with recognized standards of ethical practice and relevant federal and state regulations, and that students are prepared to understand the health care and education landscapes and how to facilitate access to services.

Students graduating from CAA-accredited programs must understand the impact of their cultural and linguistic variables on the delivery of effective care, along with the impact of those variables for their clients. CAA-accredited programs must ensure students show evidence of care, compassion, and appropriate empathy during interactions with everyone served.

ASHA strongly urges Brigham Young University to adhere to ASHA’s Code of Ethics as well as The Church of Jesus Christ of Latter-day Saints’ policies and guidelines cited above; reverse its decision; and restore voice and communication services for transgender clients.

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