Addressing Mental Healthcare in the LGBTQ Community
June 11, 2021   

In this NEI Podcast episode, NEI sat down with Drs. Rhonda Schwindt and Dr. Stephen Forssell for an expert discussion on disparities in the mental health care of lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) individuals.

NEI Podcast - Episode 99
Somewhere Over the Rainbow: Addressing Mental Healthcare in the LGBTQ Community and Serving Gender Diverse Patients

with Dr. Rhonda Schwindt and Dr. Stephen Forssell

Transcript from Episode 99

NEI: What are some specialized training areas that mental health providers could benefit from so that they can better help treat patients in the LGBTQ community?

DR. SCHWINDT: I keep saying this. All of these questions hit the most important aspects of the LGBTQ community. And then, as you said, kind of shift the focus now on “what can we do as providers?” Steve, at any time, please feel free to jump in on this. I think one of the things that we must take a responsibility for is to recognize that there are unique healthcare needs of members of the LGBTQ community. And whether it’s a mental health provider like myself and Steve or in another specialty, it’s our responsibility to learn about that. It’s not the responsibility of our LGBTQ patients to teach us.

If you don’t mind, I’ll tell you just a really quick story. I had a patient say to me that he went to the dentist recently to get his teeth cleaned. And at the registration desk, he said “My name has changed”. He had changed his name and he wanted his documents now to all match up. As soon as he said it, he said he regretted it because the rest of his visit was all about his gender identity. And he said everybody from the person at the front desk to the dentist to the dental hygienist wanted to just talk to him and ask him all these kinds of questions and also just prove to him how uber affirmative they were. And he said “All I wanted was to get my teeth cleaned. It wasn’t my job to teach them. I don’t want to be the token gender diverse person. I want to be able to get my teeth cleaned just like anybody else.”

So my point to that is, we have to educate ourselves about basic terminology; about what is the difference between sexual orientation and gender identity; what are some of the unique health needs; what do people experience that are members of gender and minority groups. We also, I think, and Steve, you alluded to this early on when you mentioned cultural competence, we also have to be willing to explore our own unconscious biases. We need to undergo cultural diversity training. And we need to be willing to take a step back and be self-reflective and recognize how are we engaging in that bias and what can we do to change it. Because everybody does. It’s a matter of recognizing and then taking positive steps forward. So I think that’s one of the first places that we have to start and that’s -take responsibility as a provider first.

DR. FORSSELL: That’s great and actually I love the story about the dentist because that’s very typical. And it’s great that people want to show they’re positive and affirming but trans people and gender diverse people really are sick of being put on display. And the things that are important to remember are, asking questions, some trans people get these very probing and personal and, quite frankly, not medically necessary questions and that really does make people feel sort of objectified. I don’t think that’s very good.

I want to add one other thing too. Yes, Rhonda’s point was very good; we need to make sure that we educate ourselves and check our own biases, check our own privilege. But the gist of my program is, we as professionals, who are trained to understand these issues are in a position to, and I feel have an obligation to, train our peers.

Dr. Schwindt will be speaking at the 2021 NEI Congress this November in Colorado Springs. Her presentation “Beyond the Binary: Affirmative Mental Health Care for Transgender and Gender Diverse People” will further explore this very important topic.

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     Additional Resources:

This Month In Psychopharmacology
Association Between Gender-Affirming Surgery and Improved Mental Health
2021 NEI Congress
Beyond the Binary: Affirmative Mental Health Care for Transgender and Gender Diverse People
November 5-7, 2021 | Colorado Springs, CO and Virtual
This Month In Psychopharmacology (NEI Members Only)
Positive School Climate and Suicidality Among LGBTQ Youth