The last 10 years have seen an increase in the number of comprehensive programs providing care to transgender people, with over 20 programs currently in the US alone and many more internationally. Psychiatrists are often involved in these programs and, given their expertise in working with teams across specialties, consult-liaison psychiatrists are uniquely positioned to be able to help ensure that patients receive high quality, affirming care from their medical and surgical providers. The role of the psychiatrist in the care of transgender individuals is to assist patients in establishing their goals and readiness for gender confirming interventions; to assess for and manage any significant mental health concerns; and to liaison with the team providing confirming care on behalf of the patient. While CL psychiatrists may be called upon to care for transgender people, many feel under-equipped to address the unique aspects of transgender care. This symposium will provide knowledge on the background, treatment, and integrated care of transgender adults.
Dr. Arroyo will present on the integrated care of transgender patients. This segment will review guidelines laid out by the World Professional Association for Transgender Health and will review general medical, endocrine, and mental health needs of patients.
Dr. Linde will present on common mental health needs of transgender patients and review data addressing the outcomes of treatment.
Dr. Lichtenstein will review surgical treatment options and address the most common issues impacting mental health that arise in the inpatient medical/surgical setting which the CL psychiatrist may be called on to address.
Dr. Faeder will present on the pre-surgical evaluation for gender affirming procedures, which is modeled on the psychiatric transplant evaluation with several significant differences. He will discuss letter writing and the ethics of “gatekeeping” vs informed consent models of care.
A discussion and Q&A session will follow.
As our culture becomes more accepting of gender diversity and more people have access to transition care, psychiatrists are increasingly being called upon to evaluate and treat patients seeking these services. Furthermore, we anticipate that the future will see the development of more integrated care programs for transgender people. The multidisciplinary nature of transition care makes CL psychiatrists the best suited to help patients navigate the medical system to achieve their goals.
Winter, S., et al. (2016). Transgender people: Health at the margins of society. The Lancet, 388(10042), 390-400. doi:10.1016/s0140-6736(16)00683-8
Dhejne, C., et al. (2016). Mental health and gender dysphoria: A review of the literature. International Review of Psychiatry, 28(1), 44-57. doi:10.3109/09540261.2015.1115753