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AC-E-4, Gender Transition Plan

AC-E-4, Gender Transition Plan

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CONFIDENTIAL

This document outlines the necessary planning to support a student’s formal transition of gender from their commonly assumed status to their identified and authentic gender. The plan's purpose is to create the most favorable conditions for a physically and psychologically safe school experience, and to identify the specific actions that will be taken by the student, school, family, or other support providers.

Student’s Name and Pronouns:

School:

Today’s Date:

Legal Name:

Student’s Gender:

Assigned Gender 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, 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 supporting the student’s transition?

  • Student:
  • Parent(s):
  • School Staff:
  • Other:

Student Transition Details

What specific information 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 lessons/activities include?

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:

Communication for School Staff

Will there be specific information shared about this student's transition with school staff?

  • Y
  • N
  • When?

Who will be communicating the information to staff? What will be the content of the communication?

Questions/Notes:

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?

Who will speak with them? When? What will the request be?

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    
  Communication for school staff    
  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: