Mental Health of Transgender Veterans: Patients' Perspective on the Psychiatric Care Provided at the Local Department of Veterans Affairs Medical Center

Medical care quality and availability relate closely to an individual's geographic location, race or ethnicity, and other sociodemographic factors, including gender, education, and age. Due to difficulties with employment, lack of family support, and a high incidence of homelessness, the members of the transgender population appear to be at greater risk of exposure to healthcare-related disparities and discrimination. In addition, to healthcare access challenges, members of this population often encounter providers who lack adequate knowledge of transgender care and treatment resources. Although the World Professional Association for Transgender Health and the Veteran's Health Administration (VHA) have attempted to standardize the treatment options available to transgender individuals, little data exists regarding the benefits of the currently accessible treatment modalities. The issue is highly relevant to the veteran population because gender dysphoria (GD) is 5 times more prevalent among veterans than in the general public. In previous studies, scientists have revealed a need for additional publications that focus on evaluating the available interventions. These researchers indicate that transgender clients are more susceptible to mental health concerns and frequently use psychiatric emergency services. This scholarly project aimed to obtain objective information and elicit perceptual data from the transgender veterans receiving care at a local Veterans Affairs Medical Center (VAMC). The objectives of this project included (a) collecting demographic and mental health data to help estimate the prevalence of GD within the local VA mental health system and to identify the spectrum of services provided to transgender veterans in the specified setting; (b) gathering perceptual data from transgender veteran patients regarding their mental health needs; and (c) presenting the results of the data collection to stakeholders and the mental health nurse practitioners at the local VA facility. The data collected from the chart reviews and questionnaires supported the notion that individuals with GD/GID often have comorbid psychiatric conditions and are high utilizers of emergency psychiatric services. The information retrieved from the chart reviews helped to illustrate gaps in service utilization. Alongside, the perceptual data gained from the questionnaires provided clinicians with information regarding perceived effectiveness of currently offered interventions. In addition, this project gave veterans an opportunity to suggest actions that could enhance their treatment and to voice concerns about how they feel while receiving services at the identified location. The project findings supported the need for additional interventions. Although VHA initiatives on transgender care have helped to improve access to VA health benefits and standardized treatment options, more effort is necessary to change the environment at the facilities, improve providers' knowledge, and eliminate bias towards transgender individuals and their care.