Characteristics of Transgender Individuals With Emergency Department Visits and Hospitalizations for Mental Health

Lam, June Sing Hong; Abramovich, Alex; Victor, J. Charles; Zaheer, Juveria; Kurdyak, Paul

doi:10.1176/appi.ps.202100306

Cited by 5 publications

(17 citation statements)

References 26 publications

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“…TGD individuals presenting for emergency psychiatric services tend to be younger than non‐gender diverse persons. In Lam et al., 3 there was a statistically significant difference ( P < 0.001) between the mean ages of transgender participants (28.8 years) compared to an unmatched general population (38.3 years). Progovac and colleagues' study of Medicare beneficiaries similarly found gender minority beneficiaries as significantly more likely to be younger than 65 (gender minority 93% vs. non‐gender minority 74%, P < 0.0001) 14 .…”

Section: Resultsmentioning

confidence: 85%

“…Specifically, TGD individuals were found to be younger, more likely to live outside of rural areas, and be at risk of experiencing other societal inequities like housing instability. 3,14…”

Section: Discussionmentioning

confidence: 99%

“…Studies have also identified that compared to unmatched and matched samples, transgender participants were significantly more likely to experience internalizing symptoms or mood disorders. 3,18 Berona et al 18 found that LGBT youth were significantly more likely to receive a mood disorder diagnosis (91.6%) than non-LGBT youth (80.7%) (P = 0.01). Lam et al 3 found 26% of transgender participants, compared to 15.6% of the unmatched general population (P < 0.001) and 19% of a matched sample (matched by age, region of residence, and mental health care utilization history; P < 0.001), were diagnosed with a mood disorder.…”

Section: Mental Health Vulnerabilities In Tgd Individualsmentioning

confidence: 99%

“…They also found that compared to the unmatched general population, transgender participants were significantly more often (P < 0.001) diagnosed with personality disorders (4% vs. 0.7%), schizophrenia or psychotic disorder (5% vs. 3.4%), and to present to emergency care for self-harm (7% vs. 5.2%), and less likely to be given an anxiety, trauma, or obsessive-compulsiverelated disorder (38% vs. 46%), or a substance use disorder (14% vs. 25%). 3 Romanelli et al 19 explored service denial in transgender individuals. The connection between service denial in health care settings with increased substance use as a coping mechanism (unstandardized β = 0.037, P = 0.027), and increased rates of attempted suicide (unstandardized β = 0.044, P = 0.006) in transgender participants was found to be statistically significant.…”

Section: Mental Health Vulnerabilities In Tgd Individualsmentioning

confidence: 99%

“…This number is even greater if including the wider spectrum of gender diversity. TGD individuals are known to be at an increased risk for multiple negative mental health outcomes, including elevated rates of depression, suicidal ideation, and self‐harm behaviors 3 . As a result, TGD individuals may present to emergency psychiatric settings during mental health crises.…”

Section: Introductionmentioning

confidence: 99%

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Experiences of transgender and gender diverse patients in emergency psychiatric settings: A scoping review

et al. 2023

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ObjectiveThis scoping review aims to characterize what is known about transgender and gender diverse (TGD) individuals in emergency psychiatric settings and identify what gaps persist in this literature.MethodsA search of 4 electronic databases (PubMed, Web of Science, GenderWatch, and PsycINFO) was used for data collection. Included were studies that looked at TGD individuals presenting to a psychiatric emergency department (ED) or ED with a primary mental health concern. Study screening progress was documented in a Preferred Reporting Items for Systematic reviews and Meta‐Analyses flow chart. A total of 232 titles and abstracts were screened, 38 full texts were evaluated for eligibility, and 10 studies were included.ResultsThe studies reviewed identified mental health vulnerabilities unique to the TGD population, including service denial in health care settings, gender dysphoria, increased rates of non‐suicidal self‐injury, and in some studies an increase in suicidality. Societal inequities, including the risk of discrimination and residential instability, were also revealed. A subset of the studies identified best practices in caring for this population, including the use of non‐judgmental, affirmative, and inclusive language, and on a structural level creating emergency environments that are confidential, inclusive, and therapeutic for these individuals.ConclusionsThere is limited information on TGD individuals in emergency psychiatric settings, and thus it is difficult to form strong conclusions. However, the current evidence available suggests possible inequities in this population. Three major themes with regards to TGD individuals in emergency psychiatric settings were identified: mental health vulnerabilities, societal inequities, and best practices in caring for this population. Overall, there is a scarcity of literature in this field, and further research on the experiences of this population is needed to inform clinical practice.

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Section: Resultsmentioning

confidence: 85%

“…Specifically, TGD individuals were found to be younger, more likely to live outside of rural areas, and be at risk of experiencing other societal inequities like housing instability. 3,14…”

Section: Discussionmentioning

confidence: 99%