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How can you provide affirmative mental health care for transgender and gender diverse patients?
“I am not here to speak on behalf of the trans community. I do not presume to know their lived experience. What I do strive to do, however, is to infuse the lived experiences that they have entrusted with me into everything that I do, as a clinician, as a teacher, and as a researcher.”
In her session, “Beyond the Binary: Affirmative Mental Health Care for Transgender and Gender Diverse People,” at the 2021 NEI Congress, Rhonda Schwindt, DNP, RN, PMHNP-BC, shared information on affirmative mental health care for transgender and gender diverse people.
“Trans people have the right to determine who they are. And they have the right to expect that you will believe them. Now, in order to do that, we have to be willing to challenge that social construct that tells us gender can only exist within the binary, male female,” said Schwindt, who is an associate professor and Director of the Psychiatric-Mental Health Nurse Practitioner Program at George Washington University School of Nursing in Ashburn, Virginia.
Schwindt went on to use the example of “Michael.” Michael is a 25-year-old who identifies as a transgender male. About 6 months ago, Michael finally got a well-deserved and desired promotion; however, with that promotion came a new office in a new building with new coworkers. And almost immediately after he assumed that new position, he became the target of daily harassment, bullying, and discrimination. Michael began mapping out the nearest public restrooms, places where his coworkers could not judge him, but when realized those bathroom trips were not sustainable, he began limited his fluid intake. He then needed medical intervention for severe dehydration and constipation.
“What Michael needed was for me to be an affirming mental health care provider and to ask him about his lived experience,” said Schwindt. “When I finally did that, then we were able to bring in a team of people and work with Michael. You can't medicate away discrimination.”
Schwindt also brought up the discouraging suicide rate in the trans community: suicide attempt rates amongst transgender patients is about 40%. She stressed how assessing for specific gender identity conversion efforts is important, as it may be contributing to a trans patient’s suicidal ideation.
Overall, Schwindt reminded the audience that, “affirmative mental health care requires a holistic, client centered approach to care,” especially in the case of transgender and gender diverse patients.