Transgender and Gender Variant Populations With Mental Illness: Implications for Clinical Care

There is a scarcity of literature on clinical care for transgender and gender variant populations with serious mental illness. At times, gender identity issues among individuals with serious mental illness have been labeled as delusions that should not be reinforced by providers. However, there are significant limitations to attributing gender variance among populations with mental illness solely to a psychotic process. The following case study research demonstrates the variation in gender identity issues among individuals with serious mental illness. These individuals may experience gender dysphoria exclusively in the context of acute psychosis or may have gender identity issues that are distinct from the mental illness. Denial of an individual's gender variant presentation by treatment staff may heighten distress, thus interfering with a collaborative treatment alliance while posing additional barriers to recovery from mental illness. Implications and applications for clinical training and further research will be presented in order to promote awareness and competent care of gender issues when co-occurring with mental illness.