It has been 15 years since I wrote an editorial about hate crime against transgendered individuals (Thomas, Citation2004), prompted by reading a story in the media about Stephanie Thomas–murdered because she was living as a woman despite being born with a man’s anatomy. Sadly, I am still reading about hate crimes against transgendered individuals, especially those of color (82% of those murdered in 2018 in the USA were people of color) (Barrouquere, Citation2019). I am also seeing disturbing statistics about trans individuals who take their own lives (rates for suicidality between 37 and 65%, as cited in McCann and Brown (Citation2018).
Other disturbing statistics document high rates of anxiety, HIV, substance use disorders, and post-traumatic stress disorder in transgender people (Abeln & Love, Citation2019; McCann & Brown, Citation2018). These mental health issues can be explained by sexual minority stress theory, which points to societal stigma, discrimination, and harassment as likely etiologies (Flaskerud & Lesser, Citation2018). Disparities in both medical care and mental health care are well-documented, and the unique care needs of transgender individuals have been obscured by researchers’ tendency to group them with lesbian, gay, and bisexual people—as though LGBT people were a homogeneous group (Thomas, Citation2016).
Has any progress been made since I wrote that 2004 editorial? Surprisingly, my answer to the question is “yes,” with regard to greater societal acceptance of transgender people in highly visible public roles (e.g., politics and entertainment), and better training of police (e.g., to use a person’s preferred pronoun, allow requests for a specific gender to conduct body searches, and other measures to preserve the dignity of trans people in their interactions with law enforcement) (Barrouquere, Citation2019). Of more direct relevance to the readers of this journal, progress is also being made within the medical and psychiatric-mental health professional community, especially with regard to education of providers and training of students. The American Psychological Association (APA) published Guidelines for Psychological Practice with Transgender and Nonconforming People in 2015 (APA, Citation2015). Brittany Abeln and Love (Citation2019), in the June issue of this journal, provided specific suggestions for improvements in education of nurses about care of the transgender population and use of culturally competent transgender terminology.
Research has increased on the health of transgender individuals (e.g., Bockting, Miner, Swinburne Romine, Hamilton, & Coleman, Citation2013; Downing & Przedworski, Citation2018) and the education needs of their families (Sharek, Huntley-Moore, & McCann, Citation2018). Citing an Institute of Medicine Report (IOM) from 2011, Buchholz had noted that the research base on transgender-specific issues was once “so thin that the word ‘gap’ wasn’t applicable” (cited in Buchholz, Citation2015, p. E1). Undoubtedly, some gaps in the empirical literature remain, such as under-representation of persons of color (noted by McCann & Brown, Citation2018). But the number of articles published in professional journals for physicians and nurses has greatly increased since that 2011 IOM report. For example, a quick PubMed search this morning revealed 96 articles published, thus far, in 2019, including the above-cited article by Abeln and Love in the June issue of Issues in Mental Health Nursing.
In many of the newer articles, authors are moving beyond recitation of the statistics about mental disorders of transgender people, and the inept and unkind care they often receive, to describing resilience of transgender people (Bockting et al., Citation2013) and ways to create an atmosphere of transinclusivity in all settings of medical and psychiatric care (Abeln & Love, Citation2019). Issues in Mental Health Nursing has contributed toward closing the gaps in the literature, as evidenced by the excellent articles we have recently published by McCann and Brown (Citation2018), Harmon and Donohue (Citation2018), Sharek, et al. (Citation2018), Flaskerud and Lesser (Citation2018), and Abeln and Love (Citation2019). Progress is being made, and will continue with your manuscript submissions. You are invited to join the dialog.
References
- Abeln, B., & Love, R. (2019). Bridging the gap of mental health inequalities in the transgender population. Issues in Mental Health Nursing, 40(6), 482–485.
- American Psychological Association (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70, 832–864.
- Barrouquere, B. (2019 Spring). Under attack. Intelligence Report, 166, 19–24.
- Bockting, W. O., Miner, M. H., Swinburne Romine, R., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951.
- Buchholz, L. (2015). Transgender care moves into the mainstream. Journal of the American Medical Association, 314(17):1785–1787.
- Downing, J. M., & Przedworski, J. M. (2018). Health of transgender adults in the U.S., 2014–2016. American Journal of Preventive Medicine, 55(3), 336–344.
- Flaskerud, J. H., & Lesser, J. (2018). The current socio-political climate and psychological distress among transgender people. Issues in Mental Health Nursing, 39(1), 93–96.
- Harmon, K., & Donohue, G. (2018). “Not becoming mother”: A phenomenological exploration of the therapeutic relationship with transgender clients. Issues in Mental Health Nursing, 39(1), 53–58.
- McCann, E., & Brown, M. (2018). Vulnerability and psychosocial risk factors regarding people who identify as transgender: A systematic review of the research evidence. Issues in Mental Health Nursing, 39(1), 3–15.
- Sharek, D., Huntley-Moore, S., & McCann, E. (2018). Education needs of families of transgender young people: A narrative review of international literature. Issues in Mental Health Nursing, 39(1), 59–72.
- Thomas, S. P. (2004). Rising violence against transgendered individuals. Issues in Mental Health Nursing, 25(6), 557–558.
- Thomas, S. P. (2016). Hate crime, medical care, and mental health care for transgender individuals. Issues in Mental Health Nursing, 37(4), 209–210.