“We know that transgender individuals, whether they’re binary or nonbinary, are at higher risk for psychological distress and suicide, so this is immensely important for us as mental health nurses,” said Dallas M. Ducar, MSN, RN, PMHNP-BC, CNL, during her keynote address presented at the 2021 Fall Nursing Conference.
The CEO of Transhealth Northampton, a health care center created to “empower trans and gender-diverse adults, children, and families,” Ducar called on the nurses in attendance to adopt gender-affirming practices and work to close gaps in care access.
Her talk, “Affirming and Empowering Mental Health Care for Gender-Diverse Individuals,” explored the many mental and physical health challenges facing gender-diverse populations. Ducar examined legal issues, societal attitudes, and medical practices that often act as barriers to care for these individuals. Also, she explained how gender-affirming mental health and medical practices can improve services and outcomes.
Health Care Gaps
Ducar reported findings from the 2015 U.S. Transgender Survey. This investigation found that 39% of transgender individuals responding to the survey said they were currently experiencing serious psychological distress, and most said these issues interfered with their daily lives. That 39% is eight times the national average.
Also, Ducar cited a 2014 Fenway Health survey that demonstrates the impact of discrimination on transgender patients. The survey found that 20% of respondents postponed or did not receive health care services because of past or perceived discrimination.
“We see many gaps in health care for disabled people, people of color, undocumented people, incarcerated people, LGBTQ folks, and, specifically, transgender people of color,” Ducar stated. “Systemic oppression really locks people out of care.”
Delaying or forgoing care, Ducar stated, leads to more severe physical and mental health issues for these patients. Drawing from her own experience working with patients, Ducar said that putting off care can lead to substance use disorders, housing insecurity, and other serious mental, physical, and societal issues.
What Can Be Done?
Having detailed the health care access issues facing transgender people, Ducar turned to presenting solutions.
She called on the nurses in attendance to better understand the varieties of gender identity, gender expression, emotional attraction, and sexual attraction, and she encouraged health care professionals to use appropriate pronouns and language in working with gender-diverse populations.
She also offered practical advice to the audience on engaging with transgender youth and those who may be transitioning. Ducar called on the nurses to work closely with the families of transgender youth, particularly those who are transitioning.
She also asked nurses to advocate for and support patients in clinical settings and to make changes to inpatient units to create more welcoming and appropriate environments for care.
“This gender-affirming care is not rocket science,” Ducar said.
“I think nurses are really poised to be able to do this. It involves seeing all the layers of the individual, treating the whole person, and really trying to help the person understand their own identity and their narrative. This is not about making assumptions or relying on someone to teach, either, but really being open and curious in new ways.”
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