2025/09/05 by June Sing Hong Lam, Paul Kurdyak, Sami George Sabbah +12
Psychology · #LGBTQ Health, Identity, and Policy #Sexuality, Behavior, and Technology
paper · doi:10.1080/26895269.2025.2554293
Background Transgender and gender diverse (TGD) people experience disproportionately high rates of mental health challenges, often leading to increased use of acute psychiatric care (emergency departments and hospitalizations). However, little is known about their lived experiences during and after such care.Aim To explore the lived experiences of TGD individuals in acute psychiatric care and examine how these experiences shape post-discharge trajectories.Method Using constructivist grounded theory, we conducted a qualitative study with 15 TGD individuals in Toronto, Ontario, who had received acute mental healthcare. Participants were recruited from both clinical and community settings. Data were analyzed inductively to identify patterns in experiences and care pathways.Results Cumulative minority stress, stemming from trauma, neurodivergence, physical health conditions, and social marginalization, contributed to mental health crises and influenced help-seeking. Participants’ acute care experiences were shaped by autonomy, safety, and perceived usefulness, which informed three post-discharge pathways: engagement with formal mental health services, often facilitated by positive care experiences and access to dialectical behavior therapy; care through community organizations offering holistic, identity-affirming support; and avoidance of the mental health system following re-traumatization and loss of agency. Community-based care was seen as more effective than the biomedical model in addressing autonomy and social determinants of health.Conclusion Acute mental healthcare systems must be reformed to better support TGD individuals by addressing systemic transphobia, integrating trauma-informed, intersectional approaches, and embedding community partnerships within formal care structures. Policies centering autonomy and validating lived experience may enhance engagement and improve outcomes during and after crises.