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From Retraumatization to Recovery: Making Acute Psychiatric Care Work for Transgender and Gender-Diverse People
Rashmi de Silva Wijeyeratne1, Juveria Zaheer1,2, Jasdeep Alexander Sidhu3
1General and Health Systems Psychiatry Division, Centre for Addiction and Mental Health, Toronto.
Psychiatric Services (Washington, D.C.)
|June 3, 2026
Summary
Transgender and gender-diverse individuals often find psychiatric care traumatizing due to stigma. Implementing specific changes in care, like respecting names and pronouns, can reduce trauma and improve outcomes.
Area of Science:
- Psychiatry
- Mental Health
- Social Determinants of Health
Background:
- Transgender and gender-diverse (TGD) individuals frequently report acute psychiatric care as traumatizing.
- Structural stigma, including misgendering and medication discontinuation, contributes to negative experiences.
- These experiences can lead to disengagement from care and poorer mental health outcomes.
Purpose of the Study:
- To outline feasible changes in acute psychiatric care settings to reduce traumatization for TGD individuals.
- To improve continuity of care and mental health outcomes for TGD populations.
- To leverage lived-experience evidence and population data to inform practice.
Main Methods:
- Utilized lived-experience evidence from TGD individuals.
- Analyzed population-based data to identify key areas for improvement.
- Framed proposed changes within the context of social determinants of mental health.
Main Results:
- Standardized documentation and display of chosen names and pronouns are crucial.
- Consistent access to gender-affirming medications and gender expression items is necessary.
- Trauma-informed de-escalation, involvement of chosen family, and proactive postdischarge supports are recommended.
Conclusions:
- Proposed interventions are feasible in hospital and emergency settings.
- These changes can reduce patient disengagement, repeat crises, and outcome inequities for TGD individuals.
- Addressing structural stigma is essential for equitable mental healthcare delivery.
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