Dating a med student

Transgender people may seek services from mental health providers when they come to realize that their gender identity does not match the sex they were assigned at birth, or when the distress of this incongruence becomes intolerable.The age at which this realization occurs, and the age at which treatment is initially sought, may vary greatly from one person to the next.Trans Lifeline is a crisis hotline staffed by and for transgender people and can be included in safety planning with patients.[11]Transgender people seeking care for mental health concerns require culturally competent providers.[1] This includes basic knowledge gender identity.Transgender patients should not be placed in the position of training their providers about their mental or physical health care needs. Sharon, MDMental health is vital to positive physical outcomes and, as for all patients, should be addressed for transgender patients in primary care.Screening should include primary mental health problems, environmental and social stressors, and gender-related needs.Referrals should be made when appropriate to substance abuse treatment programs, including dual diagnosis programs for those with co-occurring mental illness.

In a recent publication, Machtinger and colleagues describe a theoretical framework for providing trauma-informed primary care.[5] The model is based on the needs of women who have a history of trauma.Transgender people with intersecting identities such as race, ethnicity, or socioeconomic status face increased likelihood of adverse life events.Transgender women of color face extraordinarily high rates of social and health disparities.[13-16] Routine primary care visits should always assess for housing, food, financial, and safety concerns in living and/or work environments.Offering referrals for individual and group therapy and support can bolster protective factors in lieu of the extreme hardships many endure.[17,18]According the Diagnostic and Statistical Manual for Mental Disorders (5th ed.) a person may be diagnosed with a mental health disorder ("Gender Dysphoria") if their gender identity does not match the sex they were assigned at birth, and they are suffering clinically significant distress or social/occupational impairment.[6] A diagnosis may provide an explanation for their gender concerns.However, receiving a Gender Dysphoria diagnosis may be perceived as pathologizing.[19] The issue of diagnosis is further complicated by a lack of a diagnostic code for the care of those with a history of gender transition of some kind who no longer experience significant distress or social/occupational impairment.

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