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Identifying and Characterizing the Transgender and Nonbinary Population Presenting to Pediatric Psychiatry Emergency
Wyatt Kim1, Kathleen R Donise2,3,4, Katherine A Brown5
1The Warren Alpert Medical School of Brown University, Providence, RI.
Summary
Transgender and nonbinary (TGNB) youth visiting psychiatric emergency services show higher rates of repeat high-acuity visits and suicidal ideation evaluations. This highlights an urgent need for improved mental healthcare access and quality for TGNB youth.
Area of Science:
- Psychiatry
- Pediatrics
- Health Equity
Background:
- Transgender and nonbinary (TGNB) individuals face elevated risks for mental health issues like depression and suicide attempts.
- Existing research often excludes the full pediatric age range or focuses outside emergency department (ED) settings.
- Understanding the mental healthcare needs of TGNB youth in psychiatric EDs is critical.
Purpose of the Study:
- To investigate the documentation of gender identity in electronic health records.
- To identify and characterize pediatric TGNB patients within a psychiatric emergency service.
- To analyze mental health outcomes and healthcare utilization patterns among TGNB youth.
Main Methods:
- Retrospective chart review of electronic health records.
- Identification of TGNB patients through gender identity documentation.
- Comparison of psychiatric emergency service utilization between TGNB and non-TGNB pediatric patients.
- Analysis of visit acuity, repeat visits, and presence of suicidal ideation.
Main Results:
- A higher percentage of TGNB patients had repeat ED visits for high-acuity psychiatric concerns compared to non-TGNB individuals.
- A larger proportion of TGNB patients had at least one evaluation including suicidal ideation.
- TGNB youth represent a significant demographic within the psychiatric emergency service population.
Conclusions:
- TGNB youth experience a disproportionate burden of high-acuity psychiatric concerns and suicidal ideation in the ED setting.
- Current mental healthcare systems may not adequately address the needs of TGNB youth.
- Enhanced attention to the quality of mental healthcare for TGNB youth, both within and beyond the ED, is urgently required.
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