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).
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. APA must be strictly followed. Minimum 5 references should be utilized to validate answers. Paper should be minimally 6-7 pages long not counting cover and reference pages.
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