Transgender Women with Severe Mental Illness and Homelessness: A Retrospective Case Series

Abstract

Transgender women (TW) with Severe Mental Illness (SMI) are one of the most vulnerable and most difficult to engage in order to receive medical attention population, raising major challenges in their treatment of adverse health conditions. A retrospective chart review was carried out to identify TW with SMI attended by the "Programme for the Psychiatric Care of the Homeless Mentally Ill" in Spain from June 2015 to June 2018. During the study period, 235 patients with SMI received psychiatric care, of which only 3 (1.3%) were TW. Sociodemographic and clinical variables of these patients are described. We conclude that TW with SMI suffer significant levels of discrimination, stigma, and physical violence. This stigma plays an important role in limiting the opportunities and access to resources in a number of critical domains (e.g., medical care, disability certificate, accommodation in shelters) while continuously having a detrimental effect on their mental health. Forced migration in TW with SMI, must be specially considered. In addition homelessness and social exclusion are structural risk factors for HIV in TW with SMI. Social, health and psychiatric care may moderate the effect of stressors on mental health, reduce social isolation, and build social networks.

Relief for Psychiatric Patients in Malaysia: Results from expert interviews

“…In safeguarding the PMI's rights, collaboration or partnership inter-agencies should be undertaken under the just framework. Actors such as government, private, non-governmental bodies, and grassroots movements should convey their assets to the PMIs' empowerment (García-Andrade et al, 2019).…”

Homeless experiences and support needs of transgender people: A systematic review of the international evidence

“…These issues can result in minority stress due to negative responses to psychosocial stressors (Testa et al., 2017). The psychological impact may manifest in mental illness, including anxiety, depression, alcohol and substance use and suicidality (García‐Andrade et al., 2019; Hughto et al., 2019; Scheim et al., 2017). Some experience physical health conditions including human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) (Rosa et al., 2019).…”