From Retraumatization to Recovery: Making Acute Psychiatric Care Work for Transgender and Gender-Diverse People

Transgender and gender-diverse people frequently experience acute psychiatric care as traumatizing because of structural stigma, including misgendering, discontinuation of gender-affirming medications, and restrictions on gender expression. The authors leveraged lived-experience evidence and population-based data to outline changes that reduce traumatization and improve continuity after discharge: standardized documentation and display of chosen names and pronouns, consistent access to gender-affirming medications and gender expression items, trauma-informed de-escalation, involvement of chosen family, and proactive postdischarge supports. Framed within social determinants of mental health, these actions are feasible in hospital and emergency settings and may reduce disengagement, repeat crises, and outcome inequities.