scholarly journals From Margins to Mainstream: Creating a Rural-Based Center of Excellence in Transgender Health for Upstate, New York

2021 ◽  
Author(s):  
Carolyn Wolf-Gould
Keyword(s):  
Mental Health ◽  
Organizational Capacity ◽  
Strategic Plan ◽  
Wicked Problem ◽  
Transgender People ◽  
Professional Students ◽  
Transgender Health ◽  
Center Of Excellence ◽  
Legal Advocacy ◽  
The Individual

Transgender people face many barriers to healthcare, especially in rural America. The work to decrease barriers to care and address health care disparities for this population meets criteria for a wicked problem, each of which is unique and has no clear solution. The barriers are related to the individual and society and are both formal and informal. The definition for a Center of Excellence in healthcare is loose, but these organizations aspire to serve as specialized programs that offer comprehensive, interdisciplinary expertise and resources within a medical field to improve patient outcomes. With funding and leadership training from the Robert Wood Johnson Clinical Scholars program, a group of medical and mental health clinicians worked for three years with the goal of creating a Rural-Based Center of Excellence in Transgender Health embedded within a family practice to approach the wicked problem of transgender healthcare in their region. The goals of the center were six pronged: the provision of competent and affirming medical, surgical and mental health services, training for healthcare professional students, medical-legal advocacy and patient-centered research. The team created a strategic plan, with five strategic directions, including 1) developing infrastructure and organizational capacity, 2) expanding awareness, knowledge and skills, 3) fulfilling staffing needs, 4) ensuring gender-affirming care, and 5) advancing evidence-based care. I describe our work to bring transgender health from the margins to the mainstream for our region through implementation of this strategic plan.

Black U.S. Sexual and Gender Minority Mental Health

2020 ◽  
pp. 173-185
Author(s):  
Jonathan Mathias Lassiter ◽  
Lourdes Dolores Follins ◽  
Stacy W. Smallwood ◽  
Leo Wilton ◽  
Alishia Alexander ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
The United States ◽  
Structural Level ◽  
Transgender People ◽  
Individual Level ◽  
Gender Minority ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
The Individual

This chapter provides a comprehensive and nuanced review and critique of the extant scholarship related to Black sexual and gender minority (SGM) mental health in the United States. The authors highlight the determinants of mental health, the prevalence of mental health problems and inequities, and protective and resilience factors related to Black SGM mental health within five different subgroups: transgender people, intersex people, bisexual people, lesbians, and gay/same-gender-loving men. An intersectional approach is used to draw attention to how racial, gender, socioeconomic, and sexual orientation identities at the individual level influence experiences of oppression at the structural level to synergistically impact mental health. The chapter concludes with a discussion of the gaps in the literature related to Black SGM mental health and recommendations for addressing them.

scholarly journals Mental Health Care of Transsexual, Transgender and Gender Nonconforming People in Croatian Health System

2016 ◽  
Vol 9 (1) ◽  
pp. 26-26
Author(s):  
I. Zegura ◽  
◽  
G. Arbanas ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health System ◽  
Gender Transition ◽  
Transgender People ◽  
Transgender Health ◽  
Objective Health ◽  
Transgender Persons

Objective: Health and legal care of transgender people in Croatia is still at its beginnings. Further effort from the professional side is being engaged in order to establish complete health care of transgender people in Croatia. Design and Method: The aim was to examine if there are any differences in the levels of transgender persons quality of life, experienced violence and their present stage of gender transition and perceived level of social support and perceived quality of health care. Transgender clients who are in the process of gender transition within Croatian mental health system were asked to fill in the online questionnaire. Results: 80% of our transgender participants consider psychologists as the most competent and affirmative professionals concerning transgender health care. 15.6% say the same for psychiatrists and 4.4% consider endocrinologists as the most competent professionals to deal with transgender health issues. 28.8% of our participants are mostly or completely satisfied with mental health care, in contrast to only 6.6 % of those who are satisfied with medical health care. Conclusions: According to the facts that we have presented above, the agenda of health, mental health and legal care of transgender people in Croatia must be to build on permanent education, scientific work, ethical principles, standards of care and accessible health care. Minding the human rights of each patient, high quality of practice must be governed by the principles of competence in the work with transgender clients through affirmation of gender as personal construct of each client.

scholarly journals How the COVID-19 pandemic affects transgender health care in upper-middle-income and high-income countries – A worldwide, cross-sectional survey

2020 ◽  
Author(s):  
Andreas Koehler ◽  
Joz Motmans ◽  
Leo Mulió Alvarez ◽  
David Azul ◽  
Karen Badalyan ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Low Income ◽  
Social Group ◽  
High Income ◽  
Transgender People ◽  
Middle Income ◽  
Transgender Health ◽  
The Impact

AbstractBackgroundSince the beginning of the COVID-19 pandemic, access to medical care was restricted for nearly all non-acute medical conditions. Due to their status as a vulnerable social group and the inherent need for transition-related treatments (e.g., hormone treatment), transgender people are assumed to be affected particularly severely by the restrictions caused by the COVID-19 pandemic. This study aims to assess the impact of the COVID-19 pandemic on the health and health care of transgender people.Methods and findingsAs an ad hoc collaboration between researchers, clinicians, and 23 community organizations, we developed a web-based survey. The survey was translated into 26 languages, and participants were recruited via various social media and LGBTIQ-community sources. Recruitment started in May 2020. We assessed demographical data, physical and mental health problems (e.g., chronic physical conditions), risk factors (e.g., smoking), COVID-19 data (symptoms, contact history, knowledge and concerns about COVID-19), and the influence of the COVID-19 pandemic on access to transgender health care and health-related supplies. To identify factors associated with the experience of restrictions to transgender health care, we conducted multivariate logistic regression analysis.5267 transgender people from 63 higher-middle income and high-income countries participated in the study. Over 50% of the participants had risk factors for a severe course of a COVID-19 infection and were at a high risk of avoiding testing or treatment of a COVID-19 infection due to the fear of mistreatment or discrimination. Access to transgender health care services was restricted due to the COVID-19 pandemic for 50% of the participants. Male sex assigned at birth and a lower monthly income were significant predictors for the experience of restrictions to health care. 35.0% of the participants reported at least one mental health conditions. Every third participant had suicidal thoughts, and 3.2% have attempted suicide since the beginning of the COVID-19 pandemic. A limitation of the study is that we did not analyze data from low-income countries and access to the internet was necessary to participate.ConclusionsTransgender people are assumed to suffer under the severity of the pandemic even more than the general population due to the intersections between their status as a vulnerable social group, their high amount of medical risk factors, and their need for ongoing medical treatment. The COVID-19 pandemic can potentiate these vulnerabilities, add new challenges for transgender individuals, and, therefore, can lead to devastating consequences, like severe physical or mental health issues, self-harming behaviour, and suicidality.

Root Cause Analyses of Suicides of Mental Health Clients

Crisis ◽  
2015 ◽  
Vol 36 (5) ◽  
pp. 316-324 ◽  
Author(s):  
Donna Gillies ◽  
David Chicop ◽  
Paul O'Halloran
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Common Factor ◽  
Data Collection Tool ◽  
Related Factors ◽  
Root Cause ◽  
Communication Problems ◽  
The Individual ◽  
Mental Health Clients ◽  
Imminent Risk

Abstract. Background: The ability to predict imminent risk of suicide is limited, particularly among mental health clients. Root cause analysis (RCA) can be used by health services to identify service-wide approaches to suicide prevention. Aims: To (a) develop a standardized taxonomy for RCAs; (b) to quantitate service-related factors associated with suicides; and (c) to identify service-related suicide prevention strategies. Method: The RCAs of all people who died by suicide within 1 week of contact with the mental health service over 5 years were thematically analyzed using a data collection tool. Results: Data were derived from RCAs of all 64 people who died by suicide between 2008 and 2012. Major themes were categorized as individual, situational, and care-related factors. The most common factor was that clients had recently denied suicidality. Reliance on carers, recent changes in medication, communication problems, and problems in follow-through were also commonly identified. Conclusion: Given the difficulty in predicting suicide in people whose expressions of suicidal ideation change so rapidly, services may consider the use of strategies aimed at improving the individual, stressor, support, and care factors identified in this study.

Childhood adversity studies as an antidote to the predominance of neo-liberal thinking in the field of mental health

2020 ◽  
Vol 29 (4) ◽  
pp. 556-563
Author(s):  
Adam Burley
Keyword(s):  
Mental Health ◽  
Childhood Adversity ◽  
Sole Source ◽  
Point Of View ◽  
Early Adversity ◽  
Potential Impact ◽  
The Individual

This is a personal and reflective piece written from a clinician's point of view on the influence that the developing awareness around the consequences of childhood adversity has had upon the discussions, thinking and practice across the areas in which they are working. It seeks to argue that the increased understanding and recognition of the potential impact of early adversity can not only enhance and deepen the understanding of an individual's difficulties, but can serve to inform how services respond in a way that takes account of this. It suggests that the research and literature on childhood adversity can offer a route map away from a model of mental health that focuses predominantly on the individual as the sole source of interest.

Protecting privacy to protect mental health: the new ethical imperative

2019 ◽  
Vol 45 (9) ◽  
pp. 604-607 ◽  
Author(s):  
Elias Aboujaoude
Keyword(s):  
Mental Health ◽  
Electronic Medical Records ◽  
Psychological Health ◽  
Medical Records ◽  
Personal Data ◽  
Psychological Development ◽  
Clinical Implications ◽  
Patient Relationship ◽  
Ethical Imperative ◽  
The Individual

Confidentiality is a central bioethical principle governing the provider–patient relationship. Dating back to Hippocrates, new laws have interpreted it for the age of precision medicine and electronic medical records. This is where the discussion of privacy and technology often ends in the scientific health literature when Internet-related technologies have made privacy a much more complex challenge with broad psychological and clinical implications. Beyond the recognised moral duty to protect patients’ health information, clinicians should now advocate a basic right to privacy as a means to safeguard psychological health. The article reviews empirical research into the functions of privacy, the implications for psychological development and the resigned sentiment taking hold regarding the ability to control personal data. The article concludes with a call for legislative, educational and research steps to readjust the equilibrium between the individual and ‘Big Data’.

Serving transgender people: clinical care considerations and service delivery models in transgender health

The Lancet ◽  
2016 ◽  
Vol 388 (10042) ◽  
pp. 401-411 ◽  
Author(s):  
Kevan Wylie ◽  
Gail Knudson ◽  
Sharful Islam Khan ◽  
Mireille Bonierbale ◽  
Suporn Watanyusakul ◽  
...  
Keyword(s):  
Service Delivery ◽  
Clinical Care ◽  
Transgender People ◽  
Transgender Health ◽  
Service Delivery Models ◽  
Delivery Models
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