By Jeremy Kidd, MD, MPH
Assistant Professor of Clinical Psychiatry
Columbia University/New York State Psychiatric Institute
New York, NY
Dr. Jeremy Kidd spoke about mental health and substance use disparities among transgender and nonbinary (TNB) individuals, including the role psychiatrists can play in supporting the health and well-being of TNB individuals.
Health disparities for TNB populations are due, in large part, to psychological distress (i.e. minority stress) resulting from prejudice and discrimination. In a 2015 study of over 27,000 TNB individuals, 23% of respondents reported delaying necessary medical care because they feared discrimination from healthcare providers. By adopting universal gender affirmation in their clinical practices, psychiatrists can create a welcoming environment for TNB patients and help to improve mental healthcare access.
Gender affirming care begins by inquiring about, and consistently using, the name and pronouns that someone uses to describe themselves and correcting colleagues when they use un-affirming language. In addition to being an important sign of respect, it can improve mental health outcomes. A recent study of TNB youth found that youth who were permitted to use their affirmed name and pronouns in all settings reported lower rates of mental health problems and suicidal ideation than TNB youth who are restricted from doing so.
When TNB people need surgery as part of their gender transition, psychiatrists are often called upon to conduct pre-surgical mental health evaluations. The APA website offers resources for this type of evaluation, including sample letters of support.
Finally, psychiatrists are in a unique position to advocate for laws and policies that expand access to gender-affirming care and reduce prejudice against TNB individuals by educating policy makers on the link between discrimination and health disparities.
