Psychiatric Quarterly

, Volume 90, Issue 3, pp 601–612 | Cite as

Identify, Engage, Understand: Supporting Transgender Youth in an Inpatient Psychiatric Hospital

  • William Acosta
  • Zheala Qayyum
  • Jack L. Turban
  • Gerrit Ian van SchalkwykEmail author
Original Paper


Transgender adolescents may require for inpatient psychiatric care, and have unique healthcare needs and can face barriers to quality care. This study sought to address limited understanding of the inpatient experience of transgender adolescents. This study uses qualitative methods to gain insight into the experience of transgender adolescents and psychiatric care providers on an adolescent inpatient psychiatric unit in the northeast United States. Semi-structured interviews were conducted with patients (9 total, ages 13–17) and unit care providers (18 total). These interviews were recorded, transcribed, and analyzed using inductive thematic analysis. Patients and providers generally reported a supportive inpatient environment. Factors that contributed to this environment were efforts by care providers to respect patients regardless of gender identity, to use patient’s preferred identifiers, and to acknowledge mistakes in identifier use. Barriers to consistently supportive interactions were also identified, including a lack of consistent identification of a patient’s transgender identity in a supportive manner during the admission intake, challenges associated with the presence of birth-assigned name and gender within the care system (e.g. in the electronic medical record, identifying wristbands, attendance rosters), and a lack of formal training of care providers in transgender cultural competency. Interviews also provided insight into how providers grapple with understanding the complexities of gender identity. Findings suggest that gender-affirming approaches by providers are experienced as supportive and respectful by transgender adolescent patients, while also identifying barriers to consistently supportive interactions that can be addressed to optimize care.


Transgender Gender identity Affirmative model Inpatient experience Adolescents 


Compliance with Ethical Standards

Conflict of Interest

Authors Turban and van Schalkwyk are currently co-editing a textbook on pediatric gender identity for Springer.

Informed Consent

Informed assent was obtained from all patient participants, explaining study procedures and the voluntary nature of their participation. Patients who agreed to participate were then asked for permission to contact their legal guardian for informed consent. Informed consent was also obtained from care providers who participated voluntarily.

Ethical Approval

All procedures performed were in accordance with ethical standards of the institutional research committee of the participating hospital system. Approval was obtained from the Institutional Review Board prior to study initiation.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • William Acosta
    • 1
  • Zheala Qayyum
    • 1
  • Jack L. Turban
    • 2
  • Gerrit Ian van Schalkwyk
    • 3
    Email author
  1. 1.Department of PsychiatryYale University School of MedicineNew HavenUSA
  2. 2.Division of Child & Adolescent PsychiatryMassachusetts General HospitalBostonUSA
  3. 3.Department of Psychiatry and Human BehaviorWarren Alpert Medical School of Brown University and Butler HospitalProvidenceUSA

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