Advocating for Transgender Adolescent Patients in Inpatient Psychiatric Units

by | May 25, 2024 | Nursing

 

Case Study 14.1: Inpatient Psychiatric Admission

Victoria (pronouns she/her/hers), 17 years old, was admitted to an inpatient psychiatric unit after an overdose. After a recent sexual assault and beating, Victoria moved in with her grandmother and lived there for 3 months prior to admission. Her grandmother is tolerant of her desire to transition, but does not approve of her “lifestyle choice,” praying that “Jesus will forgive her.” Victoria began gender-affirming hormone therapy 6 months ago, but after her mother lost her job due to the COVID-19 pandemic, she also lost her health insurance. With no insurance, she was no longer able to afford gender-affirming therapy and overdosed on amitriptyline (prescribed for anxiety and depression), but survived. When admitted, Victoria surrendered her estradiol supply, per facility policy, and later asked the charge nurse for her daily dose. First, the staff ignored her. Then, when they responded, they used her dead name, Derek, and refused to call the physician to obtain an order for the medication. The physician, who met with Victoria the following day, told her that the therapy was not safe for adolescents and encouraged her to follow up with her primary care provider after discharge.
1) What could you do immediately to advocate for Victoria?
2) What intervention would you recommend for the health professional staff to increase awareness and reduce personal biases?
3) What organizational policies would help to prevent or reduce future discrimination or inequitable treatment of transgender patients admitted to the unit?
4) What health-related concerns are essential to consider for Victoria as a transgender adolescent?
5) Script a statement to advocate for Victoria’s ongoing gender-affirming therapy based on clinical practice guidelines (Deutsch, 2016).

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

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Advocating for Transgender Adolescent Patients in Inpatient Psychiatric Units

Introduction

In the case study of Victoria, a 17-year-old transgender patient admitted to an inpatient psychiatric unit after an overdose, we are faced with a critical scenario that highlights the challenges and discrimination often experienced by transgender individuals in healthcare settings. This essay aims to address immediate advocacy steps for Victoria, recommend interventions for health professional staff to reduce biases, suggest organizational policies to prevent discrimination, identify health-related concerns for transgender adolescents like Victoria, and script a statement advocating for her gender-affirming therapy based on clinical practice guidelines.

Thesis Statement

It is imperative to advocate for transgender adolescent patients like Victoria in inpatient psychiatric units through immediate action, interventions to reduce biases among health professional staff, implementation of organizational policies to prevent discrimination, consideration of specific health-related concerns, and adherence to clinical practice guidelines for gender-affirming therapy.

Immediate Advocacy Steps for Victoria:

1. Ensure Immediate Access to Gender-Affirming Medication: Advocate for Victoria’s right to access her prescribed medication by contacting the physician or senior staff members to obtain the necessary order promptly.
2. Use Correct Name and Pronouns: Educate the staff on the importance of using Victoria’s preferred name and pronouns to affirm her gender identity and foster a respectful environment.
3. Provide Emotional Support: Offer counseling and emotional support services tailored to address the trauma and mental health needs of transgender adolescents like Victoria.

Interventions for Health Professional Staff:

1. Training on LGBTQ+ Cultural Competency: Conduct mandatory training sessions to increase awareness and understanding of LGBTQ+ issues, terminology, and best practices for providing inclusive care.
2. Encourage Self-Reflection: Encourage staff members to reflect on their personal biases and assumptions towards transgender individuals and challenge discriminatory behaviors.

Organizational Policies to Prevent Discrimination:

1. Non-Discrimination Policies: Implement clear policies that prohibit discrimination based on gender identity or sexual orientation within the healthcare facility.
2. Inclusive Language Guidelines: Develop guidelines that mandate the use of respectful and inclusive language when interacting with transgender patients.

Health-Related Concerns for Transgender Adolescents:

1. Mental Health Support: Provide specialized mental health services that cater to the unique needs of transgender adolescents, including trauma-informed care and gender-affirming therapy.
2. Hormone Therapy Monitoring: Regularly monitor hormone therapy effects, side effects, and adherence to ensure the safety and well-being of transgender patients like Victoria.

Scripted Statement for Advocating Gender-Affirming Therapy:

“As per clinical practice guidelines outlined by Deutsch (2016) and in alignment with Victoria’s treatment plan, it is essential to advocate for the continuation of her gender-affirming hormone therapy. Research supports the positive impact of hormone therapy on the mental well-being and gender dysphoria of transgender individuals. As such, I recommend that Victoria’s healthcare team reassess her hormone therapy needs and ensure timely access to prescribed medications as part of her comprehensive care plan.”

Conclusion

In conclusion, advocating for transgender adolescent patients in inpatient psychiatric units requires a multi-faceted approach that includes immediate action, staff interventions, policy changes, consideration of health-related concerns, and adherence to clinical guidelines. By implementing these strategies, healthcare providers can create a more inclusive and supportive environment for individuals like Victoria, ensuring they receive the respectful and affirming care they deserve.

 

 

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