Emma is a 54-year-old African American addiction specialist who works at a mental health clinic. Emma recently began working with Britney, a white, 26-year-old client

Emma is a 54-year-old African American addiction specialist who works at a mental health clinic. Emma recently began working with Britney, a white, 26-year-old client who is being treated for an opioid use disorder. Emma’s role as the addiction specialist is to arrange for Britney to begin Medication Assisted Treatment (MAT) and to provide addiction counseling once a week. The intake assessment indicates that, though her birth name is Bryan, she identifies as female and prefers to be called Britney. At their initial meeting, Emma notices that, though Britney wears make-up and women’s clothing, her physical appearance presents as male, as evinced by facial hair and traditionally masculine features. When Emma initially responded to Britney as a male and used her birth name, Britney informed Emma that her name is Britney and that she identifies as a woman. Emma recognizes that she is having a difficult time working with Britney because of her religious beliefs about the LGBTQ+ population.