TY - JOUR
T1 - The Provider Perspective on Behavioral Health Care for Transgender and Gender Nonconforming Individuals in the Central Great Plains
T2 - A Qualitative Study of Approaches and Needs
AU - Holt, Natalie R.
AU - Hope, Debra A.
AU - Mocarski, Richard
AU - Meyer, Heather
AU - King, Robyn
AU - Woodruff, Nathan
N1 - Funding Information:
This work was supported in part by Grant MH108897-01A1 from the National Institutes of Mental Health
Publisher Copyright:
© 2019 Global Alliance for Behavioral Health and Social Justice
PY - 2020
Y1 - 2020
N2 - Transgender and gender nonconforming (TGNC) individuals interact with mental health care systems at high rates and experience substantial barriers to care. Rural TGNC individuals face additional disparities in accessing appropriate mental health services. Little research has focused on the mental health care providers who work with TGNC individuals in underserved areas. The current study sought to describe the mental health care services delivered by providers perceived as affirming by TGNC community members in the Central Great Plains. We conducted qualitative interviews with 10 providers to understand how providers seek cultural competency and conceptualize and work with their TGNC clients given the barriers to care. Providers held diverse theoretical orientations and described challenges to working with TGNC clients, including the impact of stigma and marginalization and financial and structural barriers to care. Emphasis was placed on individualizing care, helping clients to manage stigma and build resiliency, connecting clients to resources (when available) and support systems, and navigating the intersections of physical health care and mental health care, such as writing letters for medical transition. Providers largely educated themselves on TGNC topics and had previous experience working with marginalized populations. Overall, the providers’ approaches to working with TGNC clients mapped onto models of cultural competency, but few providers described their work in the context of an evidence-based model. Implications for increasing the quality and availability of mental health care services for TGNC individuals in underserved areas are discussed.
AB - Transgender and gender nonconforming (TGNC) individuals interact with mental health care systems at high rates and experience substantial barriers to care. Rural TGNC individuals face additional disparities in accessing appropriate mental health services. Little research has focused on the mental health care providers who work with TGNC individuals in underserved areas. The current study sought to describe the mental health care services delivered by providers perceived as affirming by TGNC community members in the Central Great Plains. We conducted qualitative interviews with 10 providers to understand how providers seek cultural competency and conceptualize and work with their TGNC clients given the barriers to care. Providers held diverse theoretical orientations and described challenges to working with TGNC clients, including the impact of stigma and marginalization and financial and structural barriers to care. Emphasis was placed on individualizing care, helping clients to manage stigma and build resiliency, connecting clients to resources (when available) and support systems, and navigating the intersections of physical health care and mental health care, such as writing letters for medical transition. Providers largely educated themselves on TGNC topics and had previous experience working with marginalized populations. Overall, the providers’ approaches to working with TGNC clients mapped onto models of cultural competency, but few providers described their work in the context of an evidence-based model. Implications for increasing the quality and availability of mental health care services for TGNC individuals in underserved areas are discussed.
KW - Cultural compentency
KW - Mental health providers
KW - Rural or underserved
KW - Stigma and marginalization
KW - Transgender and gender minority
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U2 - 10.1037/ort0000406
DO - 10.1037/ort0000406
M3 - Article
C2 - 30920242
AN - SCOPUS:85063461030
SN - 0002-9432
VL - 90
SP - 136
EP - 146
JO - American Journal of Orthopsychiatry
JF - American Journal of Orthopsychiatry
IS - 1
ER -