Index

AA (Alcoholics Anonymous), for treatment of SUDS,

241

AAPI. See Asian American and Pacific Islander communities

AASs (Anabolic-androgenic steroids), as drug of abuse,

234–235

ABA (applied behavioral analysis), for treatment of autistic children,

113–114

Ableism

.See also Disabled TNG people

definition of,

133

description of,

132

medical,

133

ACA (Patient Protection and Affordable Care Act),

300, 317, 348

Acamprosate, for treatment of SUDs,

240

Acculturation, description of,

146–147

ACLU (American Civil Liberties Union),

143–144, 318

Acne,

60

ADA. See Americans With Disabilities Act

ADA Amendments Act of 2008,

350

Adderall, for ADHD symptom management,

116

Addiction

.See also Substance use disorders

definition of,

230–231

language used for,

230–231

MAT for treatment of,

239–241

ADHD, among TNG people

abuse related to,

115

background,

110

comorbid conditions with,

115

diagnosis of,

114–115

“double empathy problem” and,

117

incidence,

114

lifetime prevalence of,

114

research equity,

118

treatment and clinical care

health care provision,

115–116

medication,

116

Adolescents. See Youth

Adult Family Care Homes of Maine,

207

AEDs. See Anti-epileptic drugs

AFAB. See Assigned female gender at birth

AFFIRM, description of,

192

Age. See Children; Older adults, TNG; Youth, TNG

“Age in place” supportive services,

207

Agender, descriptive characteristics of,

32

Alcoholics Anonymous (AA), for treatment of SUDs,

241

Alcohol use

among TNG youth,

186

as drug of abuse,

233

Alcohol Use Disorders Identification Test,

7

Algorithms of oppression,

220

AMAB. See Assigned male gender at birth

Ambiguous, descriptive characteristics of,

32

Amenorrhea,

222

American Civil Liberties Union (ACLU),

143–144, 318

American College of Obstetricians and Gynecologists,

255

American Sign Language (ASL) interpreter for TNG people,

132

American Society of Addiction Medicine (ASAM),

237

Americans With Disabilities Act (ADA),

134, 348

protections for TNG people,

348–351

Amitriptyline, side effects of,

57

Amnesty International,

144

Amphetamines

for ADHD symptom management,

116

as drug of abuse,

233

Anabolic-androgenic steroids (AASs), as drug of abuse,

234–235

Analytic third,

176

Androgen response element (ARE),

37

Androgynous, descriptive characteristics of,

32

ANI (Autistic Network International),

110

“Anonymous, Dr. H.,”

355

Anti-capitalist politic, in disability justice framework,

130

Anticonvulsants, during the perioperative period,

62

Antidepressants, during pregnancy,

255

Anti-epileptic drugs (AEDs)

GAHT and,

52

during puberty,

53

Antipsychotic drugs

GAHT and,

52

“lipid-friendly,”

268

during the perioperative period,

62

during pregnancy,

256

during puberty,

53

side effects of,

57

for treatment of SMI in TNG people,

267

Antiretroviral medications, for prevention or treatment of HIV,

268

Anti-TNG hatred,

155

Anxiety disorders

characterization of,

2, 292

in children,

3

in cisgender students,

2

epidemiological overview of mental health outcomes in TNG people,

2–4

exposure to address avoidance among TNG youth,

194

morbidity among TNG populations,

3

neurotic,

177

outcomes associated with GICE,

292

prevalence among TNG people,

2

types of,

3

in youth,

3

Apicha Community Health Center,

105

API Forward Movement,

106

Applied behavioral analysis (ABA), for treatment of autistic children,

113–114

ARE (androgen response element),

37

Aromatase, testosterone and,

58

Aromoxetine, for ADHD symptom management,

116

ASAB (assigned sex at birth),

310

ASAM (American Society of Addiction Medicine),

237

Asasumasu, K.,

111

ASD. See Autism spectrum disorder

Asian American and Pacific Islander (AAPI) communities

access to mental health services,

104–105

gender-affirming psychiatric care for

mental health outcomes among TNG AAPI adults,

102–104

social contexts surrounding adverse mental health outcomes among TNG AAPI adults,

103–104

overview,

101–102

mental health service utilization by,

104–105

need for gender-affirming psychiatric care interventions,

105–106

social barriers to mental health care,

104–105

Asian Pacific Islander Queer Women and Transgender Community,

105

ASL (American Sign Language), interpreter for TNG people,

132

Assigned female gender at birth (AFAB),

234, 309, 310

Assigned male gender at birth (AMAB),

309, 310

alcohol use and,

233

Assigned sex at birth (ASAB),

310

Asylum seekers,

143

description of,

1144

forensic evaluations for,

148–149

TNG asylum and refugee claims process,

144–145

Attunement,

225

Autism spectrum disorder (ASD)

among TNG people

applied behavioral analysis,

113–114

background,

109–110

categories of,

112

comorbid conditions with,

112

diagnosis of,

111–223

in DSM-5-TR,

111

gender expectations of,

113

incidence,

109, 111

masking,

118

research equity,

118

treatment and clinical care,

112–113

during pregnancy,

256

Autistic Network International (ANI),

110

The Autistic Women and Nonbinary Network,

117

Bailey, M.,

86

Ballroom culture,

84, 93.See also LGBTQ+ people

Barbiturates, as drug of abuse,

234

Bathrooms

gender-inclusive,

336, 337

gender-segregated,

337

signage language to avoid,

338

signs,

336–337, 338, 339

Beatie, T.,

249, 251.See also Pregnancy

Behavior

.See also Eating disorders, in TNG people

gender nonconforming behaviors among TNG youth,

194

patterns of,

161

safety-seeking,

194

using exposure to address avoidance behaviors in TNG youth,

194–195

Behavioral addictions,

235

examples of,

235

Behavioral Risk Factor Surveillance System,

56

Belongingness,

22.See also Well-being

Benzodiazepines

as drug of abuse,

234

GAHT and,

52

during the perioperative period,

62

risk of fractures during puberty,

53

Biden administration,

348

Biopsychosocial model of addiction,

236

BIPOC. See Black, Indigenous, and people of color

Bipolar disorder, during pregnancy,

255–256

Black, Indigenous, and people of color (BIPOC)

discrimination against,

17–18

lack of health care for,

293–294

support and rejection of TNG youth,

195

TNG youth and,

185

Black TNG people

barriers to health care,

90–92

clinical mistrust and cultural humility,

90–91

cost and insurance barriers,

91

siloed treatment modalities lacking intersectional understandings,

91–92

stigma for being transgender or Black or both,

91

culture of,

86

depression among,

5

disenfranchisement of,

86

diversity within the community,

87–89

Black immigrants,

87–88

claim to sameness,

88–89

rural versus urban communities,

88–89

facilitators to treatment and positive mental health social support through queer family structures,

92–94

community activism,

93–94

overview,

92

religious engagement,

93

social and material support in ballroom culture,

93

housing discrimination against,

86

as immigrants,

87–88

incarceration of,

276

legacies of slavery and forced migration,

86

medical experimentation on,

90–91

mental health care and,

83–84

prevalence of mental and behavioral health disorders in,

84–87

historic lineages affecting Black trans mental health,

85–87

impact of violence and victimization among,

84–85

limitations of the current research,

87

overview,

84

redlining,

86

slavery legacy of,

86

social determinants of health in,

89–90

incarceration status,

89–90

socioeconomic status, income, and education,

89

violence against,

85

“walking while Back and trans,”

86

Blatt v. Cabela’s Retail, Inc.,

349, 350

BMD (bone mineral density Z score),

51, 223

BMI. See Body mass index

Bodily vigilance,

20

Body dysmorphia

.See also Eating disorders

description of,

215

in TNG people,

221–223

Body image, in TNG people

among TNG people,

216, 217–218

gender-affirming care and body dysmorphia in TNG people,

221–223

physical presentations and sources of distress of gender dysphoria,

216, 217–218

secondary sex characteristics and,

216

social and environmental factors contributing to,

216, 219–221

Body mass index (BMI)

eating disorders and,

223

GnRHas and,

51

puberty and,

53

Bone mineral density (BMD) Z score,

51, 223

Borderline personality disorder (BPD),

264–265

description of,

264

gender-affirming care of people with,

265

prevalence in TNG people,

264

stigma of,

264

Bostock v. Clayton County, Georgia,

348

BPD. See Borderline personality disorder

Brain, gender/sex characteristics in,

37

Brooks, V.,

17

Bullying,

115

Buprenorphine, for treatment of SUDs,

239

Bupropion,

57

for ADHD symptom management,

116

for treatment of SUDs,

240

Butler, J.,

179, 249, 250.See also Pregnancy

Calcium,

52

Canada, asylum in,

144

Cancer, endometrial,

222

Cannabis

as drug of abuse,

234

use among TNG people,

7

Cannabis Use Disorder Identification Test,

7

Carbamazepine

during pregnancy,

255

side effects of,

60

Case examples

of displacement,

139–140

of GAHT,

61

of GnRHas,

50

of hormones,

54

of older TNG adults,

208–209

of perioperative medications after gender-affirming surgery,

61

of testosterone,

58

Case law

.See also Legislation

Blatt v. Cabela’s Retail, Inc.,

349, 350

Bostock v. Clayton County, Georgia,

348

Doe ex rel. Doe v. Yunits,

350

Doe v. Massachusetts Department of Corrections,

350

Romer v. Evans,

349, 350

Lawrence v. Texas,

273

Williams v. Kincaid,

350, 351

CBG (corticocosteroid-binding globulin),

55

CBT. See Cognitive-behavioral therapy

Center for American Progress,

356

Center for Epidemiologic Studies Depression Scale (CESD),

5

CESD (Center for Epidemiologic Studies Depression Scale),

5

Children

.See also Autism, among TNG people; Youth, TNG

ABA for treatment of autism in,

113–114

abuse leading to SMI,

262

coming out,

358

physical abuse among,

76

prevalence of anxiety disorders in,

3

segregation of boys from girls in Indigenous people,

73

Chromatin remodeling, description of,

38

Cisgenderism

.See also Men who have sex with men

anxiety disorder and,

2

countertransferential enactments and,

173

definition of,

xxii, 310

“passing,”

87

peers,

131

unconditional naming status of people,

313

Cisgenderism/cissexism/heterosexism

description of,

xxii

Cisgender men, incarceration of TNG women with,

277

Cisgender populations, PTSD prevalence among,

4

Cisheteronormative society, TNG people in,

49

Cisnormativity/heretonormativity

definition of,

xxii

GAS and,

300

Citralopram,

52

Civil Rights Act of 1964,

348

Clean, description of,

237

Clinicians

.See also Data; Transhealth 2TNG,172

access to networking and relationship building with local providers,

343

advocacy,

163

choices about discussing gender identity,

342

codifying patients’ responses,

324, 325–326

correctional,

281

creation of a safe place,

181

credentialing,

363

doctor-patient relationship,

342, 356–357

in data collection,

322

in GAS,

302, 304

doctor-patient relationship with youth,

342

explanations in lay terms,

162

gender-affirming care and,

358

initial and ongoing training for,

323

nondiscrimination policy for,

334

opportunities for treatment of gender dysphoria,

217–218

reactions to transphobic countertransference,

176

responsibilities for culture,

134–135

role in alleviating burden of structural discrimination against TNG people,

356

role in GAS surgery,

301

role in letter writing for GAS,

297, 301–302, 304–306

trauma-informed mental health care impact on,

163–164

treatment of psychosis in TNG people,

263–264

use of “medicalese,”

315

Clozapine, side effects of,

57, 60

Cocaine, as drug of abuse,

233–234

Cognitive-behavioral therapy (CBT),

192

for coping with TNG-specific triggers for cravings,

238–239

for discrimination and abuse while incarcerated,

280

Cognitive-processing therapy (CPT), for discrimination and abuse while incarcerated,

280

Collective liberation, in disability justice framework,

130

Colonialism

health care delivery and,

77

medical,

312

negative outcomes from violence against Indigenous people,

75–76

two-spirit people and,

73–75

The Color of Autism Foundation,

115

Columbia University Medical Center,

206

Coming out,

358

Communication

.See also Language

among neurodiverse people,

117

communication styles,

117

Community

.See also Transhealth

access to networking and relationship building with local providers,

344

accountability in gender-affirming mental health care environments,

340–341

activism in,

93–94

building gender-affirming clinical environments,

357–359

for coping and social supports during pregnancy,

256–257

cultural differences of identity, roles, and responsibilities within community systems,

72

diversity of Black TNG people within,

87–89

participatory action research in,

358

role of strengths for 2S and TNG people,

78–79

spiritual life in,

74

support of displaced TNG people,

148

trust within,

34

Community Health for Asian Americans,

105

Concealment. See Identity

Concerta, for ADHD symptom management,

116

Conversion therapy. See Gender identity conversion efforts

Coping skills

CBT for coping with TNG-specific triggers for cravings,

238–239

for development of resilience,

9

during pregnancy,

256–257

in TNG youth,

188

for treatment of eating disorders in TNG people,

225

Corticocosteroid-binding globulin (CBG),

55

Counterconditioning,

161

Countertransference. See Transphobic countertransference

COVID-19 pandemic

conspiracy theories about,

90

media coverage during,

104

prevalence of depression symptoms by AAPI adults,

103

racist media coverage of,

103–104

telehealth during,

364

CPT (cognitive-processing therapy), for discrimination and abuse while incarcerated,

280

Crenshaw, K.,

86, 187

Crimes, lack of reporting,

19

Criminal justice system, description of,

276

Cross-disability solidarity, commitment to

in disability justice framework,

120

Cross-dressing,

273

for GICE,

289

Cross-movement solidarity, in disability justice framework,

130

Crystal Meth Anonymous, for treatment of SUDs,

241

Cultural bereavement, of displaced persons,

145

Culture

.See also Two-Spirit people Black,86

clinician responsibilities and,

134–135

continuity for 2S and TNG people,

78–79

differences between identity, roles, and responsibilities within community systems,

72

genocide and,

74

humility and,

91

protective effects of connectedness among 2S and TNG people,

78

as treatment,

79

tribal,

72

Data

.See also Clinicians; Electronic health records; Gender; Gender identity

codifying patients’ responses,

324, 325–326

collecting and analyzing data to enhance the practice

analyzing and understanding,

328–330

gender identity data collection, quality, and maintenance,

322–326

data integrity categories,

325

driving data,

326

monitoring, reporting, and analyzing gender identity data,

327

overview,

321–322

preparing to analyze sex and gender data,

327–328

turning data into impact,

330–331

collection, storage, and use,

314–318

completeness of,

325–326

generic workflow for collecting GSSO data,

315, 316

health information technology systems,

322

monitoring and quality control,

326

privacy concerns,

323

reporting,

327–328

representations,

315

reviewing for quality and completeness before analysis of,

321–322

safety of,

315–316

screening rates,

330

sharing,

317–318

SOGI,

330

storage and privacy,

315–316

stratifying screening data,

326

telehealth and,

324

tools for,

327

usage,

316–317

DBT (dialectical behavioral therapy), for TNG youth,

194

Death, from tobacco-related disease,

231

Dependency, description of,

230

Depression

among Black TNG adults,

5

characterization of,

291

epidemiological overview of mental health outcomes in TNG people,

4–5

outcomes associated with GICE,

291–292

postpartum,

255

prevalence among TNG populations,

4–5

Detransitioning, of older TNG adults,

207

Dextroamphetamine, for ADHD symptom management,

116

Dextromethorphan, as drug of abuse,

234

Dialectical behavioral therapy (DBT), for TNG youth,

194

5α-Dihydrotestosterone,

57

Disability

ADA definition of,

349

definition of,

128

description of,

127–128

Disability justice framework, principles of,

130

Disabled TNG people

ableism, description of,

132

accessibility for,

135

background

disability, description of,

128

disability justice,

130

intersection of disability and TNG identities,

129

models of disability,

129

rates of disability in TNG communities,

130–131

disability justice framework,

130

discrimination against,

129

gatekeeping of services,

131–135

impact of negative medical encounters,

133–134

implications for practice,

134–135

health care for,

131–135

medical model of,

129

overview,

127–128

person-first language,

128

social model of,

129

use of identity-first language,

128

Discrimination

against 2TNG people,

182

again Black TNG people,

86

against Black TNG people

description of,

17

against disabled TNG people,

129

as distal stressor,

17–19

institutionalized,

303

of older TNG adults,

203

stress and,

303

of TNG youth,

191

Disordered eating, description of,

215

Disorders of sex development (DSD),

312

Displaced TNG people

.See also Immigrants

case example of,

139–140

community support of,

148

cultural bereavement and acculturation,

145–147

dangers and trauma during transit,

142–144

in detention facilities,

143–144

forced migration,

141–142

forensic asylum evaluations for,

148–149

in gender-segregated facilities,

144

mental health recommendations for,

147–149

migrants,

141–147

overview,

139

pre-flight trauma,

142

“proving themselves” as having gender incongruence,

149

resettlement,

147, 148

social barriers to care and wellness,

147

structural forces of,

140–141

TNG asylum and refugee claims process,

144–145

Disulfiram, for treatment of SUDs,

240

Divalproate, side effects of,

60

Diversity

.See also Youth, TNG

of Black TNG people in the community,

87–89

DNA methylation, process of,

38

Doe ex rel. Doe v. Yunits,

350

Doe v. Massachusetts Department of Corrections,

350

DoubleQueer, overview,

109

Drag queens,

84

Drugs

.See also Nonmedical prescription drug use; Substance use disorders; individual drug name

drug-drug interactions,

268–269

DSD (disorders of sex development),

312

DSM-I, terminology standards in,

313

DSM-III

2TNG identity in,

179

transgender identity in,

299

DSM-IV

diagnostic name of gender identity disorder to gender dysphoria,

131

gender identity disorder to gender dysphoria,

299

transsexualism classification in,

299

DSM-IV-TR, transsexualism classification in,

299

DSM-5

criteria for SUD,

7

definition of disordered eating in,

215

definition of eating disorders in,

215

diagnosis of gender dysphoria,

350

gender dysphoria in,

xix, 299

prevalence of anxiety disorders among TNG patients,

2

DSM-5-TR

diagnosis of autism,

111

gender dysphoria diagnosis in,

21, 185–186, 299

substance use disorder in,

230

Dual-energy x-ray absorptiometry (DXA),

223

DXA (dual-energy x-ray absorptiometry),

223

Dysmenorrhea,

54

E2 levels, estrogen and,

55–56

Eating disorders, in TNG people

.See also Body dysmorphia, in TNG people; Body image, in TNG people; Gender-affirming hormone therapy

description of,

215

diagnosis of,

224

gender-expansive treatment standards for,

225

integrated care model for,

225

mortality rates of,

216

prevention of,

224

resources for,

224–225

social media for prevention and care of,

220

sociocultural model for etiology of,

219

symptoms of,

219

tailored interventions for,

225

treatment considerations for TNG people,

223–225

ECT (electroconvulsive therapy), for GICE,

289

Edinburgh Postnatal Depression Scale,

255

Education

of Black TNG people,

89

forced or coerced education of Indigenous people,

73

initial and ongoing training for clinicians,

323

training and continued education for clinicians and health care staff,

335

EHRs. See Electronic health records

Eisenbruch, M.,

145

Elder LGBT Interprofessional Collaborative Care Program,

206

Electroconvulsive therapy (ECT), for GICE,

289

Electronic Clinical Quality Measures,

322–323

Electronic health records (EHRs)

.See also Data

clinically relevant information in,

339

data elements in,

321

emphasis on assigned sex and legal name,

160

gender field in,

316

omitting information about gender status,

318˚

prevalence of DSM-5 anxiety disorders and,

2

for TNG patients,

257–258

for trans men,

253

used for types of care,

309–310

vendors for,

324

Embodiment,

225

Emotions, regulation among TNG youth,

194

Employment, health care hiring practices,

334–335

End-of-life, preparations for older TNG adults,

208

Endometrial hyperplasia,

222

Epigenetics, description of,

38

EPSs (extrapyramidal symptoms), with psychopharmacological treatment of SMI,

267–268

ERE (estrogen response element),

37

Erythrocytosis, side effects of,

60

Estrogen,

54–57

E2 levels and,

55–56

history of,

54–55

metabolism of,

55–56

organ-derived,

54–55

synthetic,

54–55

as therapy for cisgender women,

55

Estrogen response element (ERE),

37

Euchromatin, description of,

38

Excarbezapine,

55

Extrapyramidal symptoms (EPSs), with psychopharmacological treatment of SMI,

267–268

Family

.See also Parents

acceptance of TNG youth,

190

biological,

92

chosen,

92, 210, 266

facilitators to treatment and positive mental health social support through queer family structures,

92–94

found,

92

as kinship structure,

92

psychoeducation for families of TNG youth,

195–196

queer,

92

restrooms,

336

stress and resilience among TNG youth and their families,

190–191

working with families of TNG youth,

195–196

Fat broken arm syndrome,

216

“Father of Gynecology,”

90

FDA. See U.S. Food and Drug Administration

Feinberg, L.,

250

Female, description of,

32

Female athlete triad,

222

Feminine, descriptive characteristics of,

32

Fenway Health,

205

policies of,

334

safe, inclusive restroom spaces,

339

Ferenczi, S.,

174

Fictive kin,

92

First Nations,

5, 72, 312.See also Two-Spirit people

Fluoxetine,

57

Fluvoxamine,

55

Focus groups, TNG people and,

358

Four Rs of trauma-informed care,

158

Freud, S.,

174, 175, 177, 178, 180

Fryer, J.,

355

GAD-7 (Generalized Anxiety Disorder 7-item scale),

2

GAHT. See Gender-affirming hormone therapy

GAM (Gender Affirmative Model),

191–192

GAS. See Gender-affirming surgery

Gatekeeping, in health care, definition of,

132

Gay and Lesbian American Conference,

72

“Gay identified” people,

289

Gay-Straight Alliance,

195

Gay/trans panic defense, description of,

xxii

Gender

.See also Data

affirmation of,

305, 341–342

identification documents,

351–353

appearance,

305

category-based,

251–252

characteristics in the brain,

37

components of,

33

context-based,

251–252

data about,

340

descriptive characteristics of,

32

diversities,

311–312

in EHRs,

316

incongruent,

35

markers for,

352

nonaffirmation of,

17

performance-based gender trouble,

252

pregnancy and,

249–252

pronoun use,

174

with repressed meanings,

180

response categories,

322

self-attestation,

352–353

versus sex,

34

sex datum,

310, 311

societal norms of,

220

taxonomies of,

312–313, 314

variables to define sex and gender in 1955,

309, 310

Gender, sex, and sexual orientation (GSSO) data,

315, 316

Gender Affirmative Model (GAM),

191–192

Gender-affirming care,

8, 41.See also Asian American and Pacific Islander communities; Autism, among TNG people; Health care; Psychiatry

access to,

221

ADHD and,

114–115

availability of,

50

in clinical practices,

358

development of,

202

discrimination against,

18

for GICE,

290

need for interventions among TNG AAPI adults,

105–106

for older TNG adults,

204–206

of people with BPD,

265

psychotherapy for,

171–172

for SUDs,

241–243

for TNG people,

221–223

for TNG youth,

189

Gender-affirming hormone therapy (GAHT)

.See also Eating disorders, in TNG people

access to,

221

case example of,

61

as clinician treatment option for gender dysphoria,

217–218

outcomes,

41–42, 56, 221

pre-authorization paperwork for,

356

psychopharmacological medications and,

50

for SUDs,

242

for TNG populations,

37

tobacco use as contradiction with,

231–233

in youth,

6

Gender-affirming language,

xx–xxii

Gender Affirming Letter Access Project,

160

Gender-affirming medications,

266

Gender-affirming process, SMI and,

265

Gender-affirming surgery (GAS)

.See also Cisnormativity/heretonormativity

capacity to provide informed consent,

305

doctor-patient relationship and,

304

gatekeeping,

299–301

historical context of,

298–299

impact of,

42

insurance coverage of,

300, 305

interview process,

305–306

letter writing

clinician visit with patient,

304–306

as recommendation for surgery,

299

role of the letter writer,

301–302

for surgical goals,

304

overview,

297

patient evaluation for,

298, 300

perioperative medications for,

61–63, 62

SUDs and,

242–243

TNG person’s trauma with medical personnel,

302–304

Gender and sex diversities (GSDs),

311–312

Gender assigned at birth, data collection and,

329

Gender Clinical Interventions, HB 1421,

303

Gender dysphoria

.See also Mental health

clinician treatment options for,

217–218

description of,

21, 215

diagnosis of,

114

in DSM-IV from gender identity disorder,

131

DSM-5 definition of,

350

in DSM-5,

xix, 299

in DSM-5-TR,

21, 299

diagnosis in DSM-5-TR,

185–186

from gender identity disorder,

202, 355

impact on psychiatric diagnoses,

40

physical presentations and sources of distress of TNG people,

216, 217–218

prevalence of,

2, 36

treatment for,

36–37

Gender-expansive (TNG) people,

xix

Gender exploration therapy,

291.See also Gender identity conversion efforts

Gender identity

.See also Data; Incarceration; Mental health; Neuroscience, of gender identity

data collection and,

329

fear of mistreatment by health care providers,

78

to gender dysphoria in DSM-5-TR,

185–186

multiple,

129

roommates in inpatient facilities based on,

266

self-talk about,

193

Gender identity conversion efforts (GICE)

affirmative psychiatric care,

293–294

bicycle intervention for,

289

biological,

290

contemporary understanding of,

290–291

ECT for,

289

“gay identified” people,

289

history of,

288–289

intrinsic orientation,

289

link to morality and religiosity,

288–289

medical institutions and,

289

mental health outcomes associated with,

291–293

anxiety,

292

depression,

291–292

suicidality,

292–293

overview,

287–288

puberty and,

290

quest orientation of,

289

sexual orientation change efforts,

287–288

Gender identity disorder (GID)

.See also Gender dysphoria

in DSM-IV to gender dysphoria,

131, 299

to gender dysphoria,

202, 355

Gender minority stress model (GMSR)

adapting for TNG youth,

187–190

limitations of,

187–188

Gender modality, measurement of,

310

Gender nonconformance,

171

Gender/sex

description of,

32

difference between,

32

Gender and Sexuality Alliances,

195

Gender-swap filters,

220

Generalized Anxiety Disorder 7-item scale (GAD-7),

2

Genes, gender/sex characteristics and,

36–40

Geneva Convention, 1951,

144

Genital reconstructive surgery (GRS),

202, 298.See also Genderaffirming surgery

Genocide, cultural,

74

GICE. See Gender identity conversion efforts

GID. See Gender identity disorder

Gillies, H.,

298

Glucocorticoid response elements (GREs),

37–38

GMSR. See Gender minority stress model

GnRHas. See Gonadotropin-releasing hormone analogs/agonists

Goffman, E.,

250, 251

Goldschmidt, R.,

312

Gonadal hormone receptors, description of,

39

Gonadotropin-releasing hormone analogs/agonists (GnRHas),

50–54

case example of,

50

side effects of,

51

G protein,

55

GREs (glucocorticoid response elements),

37–38

Growing Up Today Study,

5

GRS (genital reconstruction surgery),

202, 298.See also Gender-affirming surgery (GAS)

GSDs (gender and sex diversities),

311–312

GSSO (gender, sex, and sexual orientation) data,

315, 316

Halberstam, J.,

250

Hallucinogens, as drug of abuse,

234

Haloperidol,

52

Hansbury, G.,

172, 178

Harassment,

115

Haraway, D.,

xix

Harm reduction,

238

Harry Benjamin International Gender Dysphoria Association,

202, 298

Hate crimes, surrounding COVID-19 pandemic,

104

Health care

.See also Gender-affirming care; Psychiatry

access barriers for TNG persons with psychosis,

263

access to networking and relationship building with local providers,

343

advance care planning for older TNG adults,

208

affirmation of,

293–294

anti-TNG discrimination,

18

barriers to care for 2S and TNG people,

77–78, 343–344

barriers to care for Black TNG people,

90–92

barriers to care for disabled TNG people,

134

coordinated plan for,

324

delivery,

321

denial of,

156

for disabled TNG people,

131–135

discrimination of TNG people with SUDs,

230

gatekeeping, definition of,

132

gender-affirming,

41, 189

intersex,

40

lack of trust in systems of,

341

neurodiverse professionals in TNG health care,

119

for older TNG adults,

204–206

providers for disabled TNG people,

133–134

refusal to TNG people,

223

social determinants of health for 2S and TNG people,

75–77, 361

as source of trauma,

156–157

teams,

322–323, 360

triadic model of TNG health,

342

Health information technology (HIT) systems,

322, 328

Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule,

135, 323–324

Healthy Minds Study,

2

Heimann, P.,

175, 175–176

Herman, J.,

162–163

Hermaphrodite,

312

Hester, R.,

356

Heterochromatin

description of,

38

Heterosexuality, colonial understandings of,

73–74

Heterosexual matrix,

250–251

Hijra,

312

HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule,

135, 323, 324

Histrelin,

50–54

HIV, antiretroviral medications for prevention or treatment of,

268

Homelessness, among 2S abd TNG people,

76

Homosexuality,

289.See also Gender identity conversion efforts

hooks, bell,

142

Hormone-receptor complex,

37–38

Hormone receptor expression, changes in,

39

Hormones

.See also individual hormones

abrupt discontinuation of,

279

canonical hormone signaling,

38

case example of,

54

impact of hormonal milieu on psychiatric medication efficacy,

42

influence on psychiatric care,

40

noncanonical hormone signaling,

38

progesterone,

57–58

sex,

37

side effects of,

56–57

steroidal,

37

Howard Brown Health,

205

17β-hydroxysteroid dehydrogenase deficiency,

36

Hypergonadism,

54

Hyperprolactinemia,

57

Hypnotics, as drug of abuse,

234

Hypothalamic amenorrhea,

222

Iantaffi, A.,

153

ICC (interdisciplinary collaborative care) model,

205

ICD-10,

329

ICD-11

classification of TNG as a “condition related to sexual health,”

299

definition of a qualified professional for a patient seeking GAS,

298

disorders due to substance use,

230

Identification documents,

351–353

Identity

abuse related to,

76

concealment of,

20–21, 23

intersecting marginalized people,

18

invalidation,

19–20

medicalization of,

364

multiple intersecting marginalized people,

18, 155

pantribal,

72–73

pride and,

23

stigma of,

216–217

Identity-first language,

128

“Illicit substances,”

7–8.See also Substance use disorder

Immigrant Legal Resource Center,

145

Immigrants

.See also Displaced TNG people

AAPI adults,

103

Black TNG people,

87–88

Immigration Equality,

145

Incarceration

.See also Gender identity; Law enforcement; Victimization

abrupt discontinuation of hormones,

279

abuse of TNG people by law enforcement,

274

arrest,

273–275

barriers to care,

278–279

of Black TNG people,

89–90

effects on TNG people,

276

“frisking” genitalia by law enforcement,

275

housing,

278

life expectancy of TNG people,

276

medical needs of inmates,

278–279

medications for continuity of care,

281

of MSM people,

90

overview,

273

perception of TNG lying to law enforcement,

275

protective custody and,

277

rates in the United States,

275

recidivism,

281–282

reentry,

280–281

safety and,

277

segregation of inmates,

277

of 2S and TNG people,

76–77

victimization of transgender inmates,

277

Inclusion without bias, definition of,

xx

Income, of Black TNG people,

89

Indian Health Services,

77

Indigenous people,

71.See also Two-Spirit people

forced or coerced education of,

73

land rights of,

74

spirituality,

73

treaty rights of,

74

Informed consent model,

280, 305

Inhalants, as drug of abuse,

234

Inpatient facilities

roommates based on gender identity,

266

for treatment of SMI,

265

for treatment of SUDs,

238

Institute of Sexual Science,

298

InterACT,

312

Interdependence, in disability justice framework,

130

Interdisciplinary collaborative care (ICC) model,

205

International Psychoanalytic Congress (1910),

174

Intersectionality theory

changing inequities of,

188

description of,

86

in disability justice framework,

130

law enforcement and,

274

psychiatric care and,

293–294

for youth,

187–188

Intersex, description of,

32, 312

Intersex Campaign for Equality,

312

Intimate partner violence, among 2S and TNG people,

76

Intrinsic orientation, of GICE,

289

Isotretinoin, side effects of,

60

Jim Crow–era laws,

86

Johns Hopkins University School of Medicine Gender Identity Clinic,

298

GAS at,

299–300

Jorgensen, C.,

202, 298.See also Gender-affirming surgery

Jung, C.,

174

Ketamine, as drug of abuse,

234

Kinship. See Family

Lacan, J.,

180

Lamotrigine

during pregnancy,

256

side effects of,

60

Language

.See also Communication

argots,

314

clinician explanations in lay terms,

162

data collection, storage, and use,

314–318

data representations,

315

data sharing,

317–318

data storage and privacy,

315–316

data usage,

316–317

generic workflow for collecting GSSO data,

315, 316

“Dear Patient,”

324

for disabled TNG people,

127–128

DSM-I terminology standards in,

313

evolution around sex and gender,

330

framework for,

32, 34

gender-affirming,

xx–xxii

gender pronoun use,

174

hyphenation versus nonhyphenation,

xxi

identity-first language,

128

Indigenous threats to,

73

jargon,

314

labeling,

330

“medicalese,”

315

misgendering,

19

names,

313–314

person-first language,

128

pronouns,

313–314, 335

restroom signage to avoid,

338

sex labels,

32, 34

sexual dimorphisms,

35

slang,

314

spacing between words,

xxi

standardized

aspects of gender and sex,

309–314

variables to define sex and gender in 1955,

309, 310

taxonomies of sex and gender,

312–313, 314

titles,

313–314

used for addiction,

230–231

use of identity-first language,

128

using nonstigmatizing language for SUDs,

231, 232

variables to define sex and gender in 1955

gender and sex diversities,

311–312

verbal victimization of TNG youth,

191

xenophobic rhetoric toward Chinese and Chinese American populations during COVID-19 pandemic,

104

Lavender Phoenix,

105

Law enforcement

.See also Incarceration

unequal treatment of TNG people,

274

Lawrence v. Texas,

273

Leadership

building an inclusive workforce environment,

334

in disability justice framework,

130

employee resources and retention,

335–336

Legacy Community Health,

205

Lawrence v. Texas,

273

Legislation

.See also Case law

ADA Amendments Act of 2008,

350

Americans With Disabilities Act,

134, 348–351

Civil Rights Act of 1964,

348

on cross-dressing,

273

discriminatory laws originating from colonial times,

142

Gender Clinical Interventions, HB 1421,

303

Health Insurance Portability and Accountability Act Privacy Rule,

135, 323–324

HIPAA,

135

Jim Crow–era laws,

86

to outlaw practice of GICE,

288

Patient Protection and Affordable Care Act,

300, 317, 348

Prison Rape Elimination Act,

277

on sodomy,

273

targeting gender-affirming care,

303

War on Drugs,

86

Lesbian women, MST origin and,

17

Letter writing

clinician visit with patient,

304–306

as recommendation for surgery,

299

role of the letter writer,

301–302

for surgical goals,

304

Leuprolide,

50–54

LGBTQIA+ people

contemporary nonnative communities,

75

definition of,

xxi

negative health trends in,

36

LGBTQ+ people, definition of,

xxi

Life course theory,

201–202

Life expectancy, of incarcerated TNG people,

276

LifeRing,

241

Lisdexamfetamine, for ADHD symptom management,

116

Lithium,

56

during the perioperative period,

62

during pregnancy,

256

side effects of,

60

Los Angeles LGBT Center,

205

LSD, as drug of abuse,

234

“Machismo,”

274

Madsen, W,

357

Male, description of,

32

MAOIs. See Monoamine oxidase inhibitors

Marginalization

of Black women,

86

of TNG people,

155, 348, 355

Masculine, descriptive characteristics of,

32

MAT (medication for addiction treatment), for SUDS,

239–241

MDMA (methylenedioxymethamphetamine), as drug of abuse,

233–234

Medical 203,

313

Medical ableism, definition of,

133

Medical transphobia, definition of,

133

Medical trauma,

133

Medication for addiction treatment (MAT)

for SUDs,

239–241

Medications, for continuity of care while incarcerated,

281

Men

assigned AMAB,

233

descriptive characteristics of,

32

gendered legibility markers for,

220

“muscular ideal” of,

219

who have sex with men while incarcerated,

90

Menses,

217

Mental/emotional labor, definition of,

21

Mental health

.See also Americans With Disabilities Act; Gender dysphoria; Gender identity; Legislation; Public health; Quality of life; Serious mental illness; Stigma; Trauma-informed mental health care with TNG communities

AAPI access to,

104–105

AAPI denial of symptoms,

104–105

across elder care settings,

206–207

care as source of trauma,

156–157

care environments

depathologization,

341–342

overview,

333

signs, symbols, and cues to TNG people,

336–338

bathroom signs,

336–337, 338, 339

community accountability,

340–341

forms and systems,

338–340

myths and misconceptions about so-called safe zone images,

336

pronoun pins and other personal accessories,

337

public-facing materials/images,

337–338, 339

workforce development,

333–336

employee resources and retention,

335–336

hiring practices,

334–335

policies and documentation,

334

training and continued education,

335

challenges in creating inclusive and affirming care,

362–364

cost and insurance barriers to care,

91

creating a mental health care environment,

364–365

disparities among older TNG adults,

203–204

disparities in TNG communities,

16–17

ethical psychiatric care,

327

facilitators to treatment and positive mental health social support through queer family structures,

92–94

gender identity and nondiscrimination policies,

347–348, 349

identification documents for TNG people,

351–353

implications for interventions,

24–25

of Indigenous people,

77

inequities

among gender minority people, overview,

15

among TNG youth,

186–187

minority stress and resilience factors affecting the health of TNG people,

15, 16

minority stress theory

limitations of,

23–24

overview,

17

resilience and well-being,

22–23

sociopolitical context of,

23

TNG-specific minority stressors,

17–21

outcomes among TNG AAPI adults,

102–104

outcomes associated with GICE,

291–293

outcomes for 2S and TNG people,

75–77

patient evaluation for GAS,

300

positive outcomes in TNG people,

8–9

recommendations for displaced people,

147–149

service utilization by TNG AAPI adults,

104–105

social barriers to,

104–105

Men who have sex with men (MSM)

.See also Black TNG people; Cisgenderism

incarceration of,

90

Methadone

during the perioperative period,

62

for treatment of SUDs,

239

Methamphetamines, as drug of abuse,

233–234

Methylenedioxy-methamphetamine (MDMA), as drug of abuse,

233–234

Methylphenidate, for ADHD symptom management,

116

Meyer, I.H.,

252.See also Minority stress model

MGH Women’s Center for Mental Health,

256

Microtrauma, history of,

40

Migrants

.See also Displaced TNG people

violence toward,

140–141

Mindfulness, eating disorders and,

225

Minority stress model,

154.See also Stigma

biologic stressors during pregnancy,

254–256

description of,

17

discrimination and,

253

of displaced TNG people,

147

environmental stressors,

252–254

implications for interventions,

24–25

SUDs and,

236

understanding,

192–193

Minority stress theory (MST)

limitations of,

23–24

overview,

17

resilience and well-being,

22–23

sociopolitical context of,

23

TNG-specific minority stressors,

17–21

Mirtazapine, side effects of,

57

Misgendering,

19

Misogynoir, description of,

86

Modafinil,

55

during the perioperative period,

62

Models

.See also Minority stress model; Minority stress theory; Transhealth

of addiction,

235–237

biopsychosocial model of addiction,

236

Gender Affirmative Model,

191–192

gender minority stress model,

187–190

informed consent model,

280, 305

integrated care model for eating disorders in TNG people,

225

interdisciplinary collaborative care model,

205

medical model of disability,

129

operant conditioning models,

194

Organization-Activation Model,

39–40

role models for TNG youth,

195

social model of disability,

129

sociocultural model for eating disorder etiology,

219

Stress First Aid Model,

363–364

triadic model of TNG health,

342

tripartite/triphasis model of trauma therapy,

162–163

12-step program model,

241

Money, J.,

309

Monoamine oxidase inhibitors (MAOIs)

during the perioperative period,

62

testosterone and,

59

Mood-altering events,

235

Mood stabilizers, side effects of,

60

Morbidity, among TNG populations,

3

Morgenroth, T.,

250

MotherToBaby,

256

Mount Sinai Center for Transgender Medicine and Surgery,

205–206

MSM. See Men who have sex with men

MST. See Minority stress theory

Multiple intersecting marginalized people,

18, 155

“My Brother’s Pregnancy,”

253

Naloxone, for treatment of SUDs,

239–240

Nalrexone, for treatment of SUDs,

239–240

Narcotics Anonymous, for treatment of SUDs,

241

National Center for Trans-gender Equality (NCTE),

257, 280, 318

National Center for Trauma-Informed Care,

157

National Commission on Correctional Health Care (NCCHC),

279

National LGBTQIA+ Health Education Center,

334

National Survey on Drug Use and Health,

243

National Trans Discrimination Survey,

129

Native Americans,

312

NCCHC (National Commission on Correctional Health Care),

279

NCTE (National Center for Transgender Equality),

257, 280, 318

Neilson, S.,

133

Neurodivergent, description of,

111

Neurodiversity, of TNG people

characteristics of,

110–111

communication,

117

description of,

110

“double empathy problem” and,

117

law, police, and criminalization,

118–119

physical accessibility,

116–117

professionals in TNG health care,

119

Neuroendocrinology. See Neuroscience, of gender identity

Neuroscience, of gender identity

framework for understanding,

33

history of,

34–36

neuroendocrinology and,

36–40

overview,

31–34

psychiatry in practice and,

40–42

Neurosis,

180

Neurotic anxieties,

177

Nicotine-based products, as drug of abuse,

231, 233

Nicotine replacement therapy, for treatment of SUDs,

241

9-Item Patient Health Questionnaire (PHQ-9),

330

NMPDU (nonmedical prescription drug use),

230.See also Substance use disorders

“No femmes, no Asians,”

103

Nonaffirmation, description of,

19

Non-binary, descriptive characteristics of,

32

Nonbinary people,

87

Nonmedical prescription drug use (NMPDU),

230.See also Substance use disorders

habit forming,

230–231

Nortriptyline, for ADHD symptom management,

116

Nucleosomes, description of,

38

OAM (Organization-Activation Model),

38–40

Obama administration,

348

Office of the National Coordinator for Health Information Technology (ONC),

324

Olanzapine, side effects of,

57

Older adults, TNG

advance care planning and end-oflife preparations,

208

“age in place” supportive services,

207

case examples of,

208–209

chosen family of,

92, 210

detransitioning,

207

generational and cultural context of,

201–206

affirmative psychiatric care,

204–206

mental health disparities,

203–204

long-term care settings for,

206–207

mental health care across elder care settings,

206–207, 358–359

overview,

201

residential care for,

206–207

resilience of,

210

self-determination of,

204–205

social support for,

204

Oligomenorrhea,

222

ONC (Office of the National Coordinator for Health Information Technology),

39–40

Operant conditioning models,

194

Opioids, as drug of abuse,

233

The Oprah Winfrey Show,

250, 251

Organisation Intersex International,

312

Organization-Activation Model (OAM),

39–40

Organotherapy,

58

Osteoporosis,

222–223

Outpatient treatment

for SMI,

266

for SUDs,

238–239

Overeaters Anonymous,

241

Oxcarbazepine, during pregnancy,

255

Pamelor, for ADHD symptom management,

116

Pantribal identity,

72–73

Parent-child relationship,

190

Parents

.See also Family

labeled as “bad,”

191

of TNG youth,

190

Parkinsonism, with psychopharmacological treatment of SMI,

267–268

Patient-centered data collection,

315

Patient Protection and Affordable Care Act (ACA),

300, 317, 348

Patriarchy,

141

PCOS (polycystic ovarian syndrome),

222

PCP, as drug of abuse,

234

Perversion,

178

Phenobarbital,

55

PHQ-9 (9-item Patient Health Questionnaire),

330

Police, violence by,

118–119

Polycystic ovarian syndrome (PCOS),

222

Postpartum Support International,

257

Posttranslational modifications (PTMs), process of,

38

PREA (Prison Rape Elimination Act),

277

Pregnancy

gender trouble and,

249–252

home birth,

254

insurance coverage and,

257

minority stress model and,

252–257

biologic stressors,

254–256

coping an social supports,

256–257

environmental stressors during pregnancy,

252–254

postpartum depression,

255

presentation of body during,

251

support through the peripartum period,

257–258

Prescription drugs, misuse of,

8

Pride Month,

338

Prison Rape Elimination Act (PREA),

277

Process addictions,

235

examples of,

235

Progesterone,

57–58

Protecting Privacy to Promote Interoperability Workgroup,

324

Psychiatry

affirmative care with GICE,

293–294

ethical psychiatric care,

327

gender dysphoria’s impact on diagnoses,

40

impact of hormonal milieu on psychiatric medication efficacy,

42

influence of hormones on,

40

need for gender-affirming psychiatric care interventions among TNG AAPI adults,

105–106

neuroscience, of gender identity and,

40–42

Psychoeducation, for families of TNG youth,

195–196

Psychological distress,

154–155

Psychopharmacology

estrogen and estradiol,

54–57

gonadotropin-releasing hormone analogs/agonists,

50–54

case example of,

50

histrelin,

50–54

leuprolide,

50–54

leuprolide and histrelin,

50–54

overview,

49–50

perioperative medications after gender-affirming surgery,

61–63, 62

for SMI,

266–269

extrapyramidal symptoms and,

267–268

side effects in TNG people,

266–267, 268

testosterone,

58–60

Psychosis, access barriers to health care for TNG persons with,

263

Psychosocial interventions, addressing gender minority stressors and resilience with psychosocial interventions,

191–195

Psychotherapy

for gender-affirming care,

171–172

for incarcerated TNG inmates,

280

services at Transhealth,

361

Psychotic disorders,

263–264

PTMs (posttranslational modifications), process of,

38

PTSD

among cisgender populations,

4

diagnosis in TNG populations,

4

epidemiological overview of mental health outcomes in TNG people,

2–4

lifetime prevalence of,

155

prevalence among TNG populations,

4

symptoms among 2S and TNG people,

77

Puberty

.See also Gender identity conversion efforts; Youth, TNG

bone growth during,

52

undesired,

290

Puberty blockers,

50–51.See also Gonadotropin-releasing hormone analogs/agonists

Public health

.See also Mental health

among TNG people,

1

Quality of life

.See also Mental health

among TNG people,

2

decrease among trans women and trans men,

8

improvement of,

10

life course considerations,

9–10

The Queer Detainee Empowerment Project,

145

Quest orientation, of GICE,

289

Race

.See also Asian American and Pacific Islander communities; Black, Indigenous, and people of color

discrimination and,

17–19

suicide and,

5–7

Racism

media coverage of AAPI people during COVID-19 pandemic,

103–104

Rainbow Railroad,

145

Recidivism,

281–282.See also Incarceration

Recovery, definition of,

237

Recovery-oriented fellowships,

241

Refugee Health Alliance,

145

Refugees. See Displaced TNG people description of,

144

Rejection

description of,

19

as distal stressor,

17–19

expectations of,

20

Relapse, description of,

239

Relationships

access to networking and relationship building with local providers,

343

doctor-patient relationship,

342, 356–357

in data collection,

322

in GAS,

302, 304

doctor-patient relationship with youth,

342

parent-child,

190

treatment considerations and,

160–161

Religion

.See also Spirituality; 12-step programs

engagement in,

93

GICE and,

288–289

5α-Reductase deficiency,

36

Reparative therapy. See Gender identity conversion efforts

Resilience

addressing gender minority stressors with psychosocial interventions,

191–195

among TNG people,

2

among youth and their families,

190–191

description of,

22, 24

developing via coping skills,

9

fostering sources of,

195

MST and,

22–23

of older TNG adults,

210

for 2S and TNG people,

78–79

Response elements,

37–38

Retinoids, side effects of,

60

Riggs, D.,

251

Ritalin, for ADHD symptom management,

116

Romer v. Evans,

349, 350

Rosskam, J.,

254

Ryan, M.,

250

Safety

creation of a safe place,

181

establishment of,

159

during incarceration,

277

myths and misconceptions about so-called safe zone images,

336

safety-seeking behavior,

194

trauma-informed care and,

157–158

Same-sex relationships,

34

Schizoaffective disorder,

263

Schizophrenia-spectrum diagnoses,

263

Secular Organizations for Sobriety (SOS),

241

Sedatives, as drug of abuse,

234

Selective nonbenzodiazepine hypnotics, as drug of abuse,

234

Selective serotonin reuptake inhibitors (SSRIs)

GAHT and,

52

GnRHas and,

51–52

during the perioperative period,

62

Serious mental illness (SMI)

.See also Mental health; Suicide

access barriers for treatment of,

262

borderline personality disorder,

264–265

description of,

261

gender affirmation process and,

265

illness-related stigma,

262

inpatient treatment,

265

mortality and,

267

overview,

261–263

psychopharmacology for treatment of,

266–269

psychotic disorders,

263–264

schizoaffective disorder,

263

schizophrenia-spectrum diagnoses,

263

treatment environments,

265–266

treatment-resistant,

261

undertreatment of,

261–262

“whataboutism,”

264

SES (socioeconomic status), of Black TNG people,

89

Sex

.See also Data

assignment at birth,

21, 32

biological components of,

32

characteristics in the brain,

37

diversities,

311–312

versus gender,

34

secondary sex characteristics in TNG people,

216

taxonomies of,

312–313, 314

variables to define sex and gender in 1955,

309, 310

Sex Addicts Anonymous,

241

Sex hormone–binding globulin (SHBG),

55

Sex Parameters for Clinical Use (SPCU),

310–311, 316

Sexual inversion,

312–313

“Sexual inverts,”

34

Sexual orientation,

250–251

Sexual orientation and gender identity (SOGI) data,

330, 339

Sexual orientation change efforts (SOCE),

288.See also Gender identity conversion efforts

Sex workers,

236, 274

SHBG (sex hormone–binding globulin),

55

Signs, bathroom,

336–337, 339, 338

Sims, J.M,

90

Singer, J.,

110

SMI. See Serious mental illness

Snapchat, gender-swap filters and,

220

Sobriety, description of,

237

SOCE (sexual orientation change efforts),

288.See also Gender identity conversion efforts

Social media

inclusive holiday calendar,

340

in marginalized communities,

155

for prevention and care of eating disorders,

220

public messages of support for LGBTQIA+ people,

338

Social support

for older TNG adults,

204

for TNG youth,

188

Socioeconomic status (SES), of Black TNG people,

89

Sodomy,

273

SOGI (sexual orientation and gender identity) data,

330, 339

SOS (Secular organizations for Sobriety),

241

SPCU (Sex Parameters for Clinical Use),

310–311, 316

Spielrein, S.,

174

Spirituality

.See also Religion

in Indigenous community,

74

of Indigenous people,

73

suppression in Indigenous people,

74

SSRIs. See Selective serotonin reuptake inhibitors

Standards of Care (SOC; WPATH),

202, 298

Stevens-Johnson syndrome,

256

Stigma

.See also Mental health; Minority stress theory

addiction-related,

231

of autism,

112

of Black TNG people for being transgender or Black or both,

91

of BPD,

264

identity-based,

216–217

internalized,

20

SMI and,

262

structural,

17–19

of TNG older adults,

203

of TNG people,

15

Stimulants

as drug of abuse,

233–234

GAHT and,

52

St. John’s wort,

55

Stone, S.,

250

Strattera, for ADHD symptom management,

116

Stress

among TNG youth and their families,

190–191

discrimination and,

303

impact of chronic stress,

42

mental/emotional labor,

21

societal (il)legibility and,

40

of TNG people,

16

traumatic,

154–155

vicarious,

21

Stress First Aid Model,

363–364

Stressors

addressing gender minority stressors and resilience with psychosocial interventions,

191–195

addressing hypervigilance,

193–194

distal,

17

discrimination, victimization, rejection, and structural stigma,

17–19

proximal,

17, 20–21

internalized stigma, expectations of rejection, and concealment,

20–21

TNG-specific,

17–21

STRONG cohort,

3

Substance abuse, among TNG youth,

186–187

Substance Abuse and Mental Health Services Administration,

243

definition of trauma,

155–156

Substance use disorders (SUDs)

.See also “Illicit substances”

addiction, definition of,

230–231

considerations regarding genderaffirming care,

241–243

cravings and,

229

dependency,

230

discrimination of TNG people in health care settings with,

230

drugs of abuse,

231–235

DSM-5 criteria for,

7

in DSM-5-TR,

230

epidemiological overview of mental health outcomes in TNG people,

7–8

in ICD-11,

230

inpatient treatment,

238

intervention, treatment, and management of,

237–241

assessing TNG patients for treatment,

237–238

inpatient treatment,

238

medication treatment,

239–241

outpatient treatment,

238–239

overview,

237

relapse and resumed use,

239

12-step programs and other mutual help organizations,

241

language used for addiction,

230–231

models of addiction,

235–237

nonmedical prescription drug use,

230

outpatient treatment,

238–239

overview,

229–230

rates among TNG people,

7

recovery, definition of,

237

recovery groups for,

231

reporting,

8

social factors and,

236

stigma and,

231, 232

using nonstigmatizing language,

231, 232

SUDs. See Substance use disorders

Suicidal ideation, prevalence of,

6

Suicidality

among TNG youth,

186

description of,

292

outcomes associated with GICE,

292–293

Suicide

among TNG youth,

186

among transgender veterans,

6

attempts among 2S and TNG people,

77

epidemiological overview of mental

health outcomes in TNG people,

5–7

lifetime attempts of,

292–293

prevalence among TNG people,

5–6

race and,

5–7

as SMI,

265

Sustainability, in disability justice framework,

130

Systematized Nomenclature of Medicine, Clinical Terms SNOMED CT),

312–313, 314

Tardive dyskinesia

with psychopharmacological treatment of SMI,

267–268

underdiagnosis of,

268

TARGET (Trauma Affect Regulation: Guide for Education and Therapy),

280

TCT. See Transphobic countertransference

Telehealth

during COVID-19 pandemic,

364

data and,

324

Teratogenicity, during pregnancy,

255–256

Testosterone

case example of,

58

as drug of abuse,

234–235

history of,

58

hormonal shift from,

254

metabolism of,

58–59

side effects of,

59–60, 62

TGD (transgender and gender diverse), definition of,

xx–xxi

TGNB (transgender and non-binary) definition of,

xx

TGNC (transgender and gender nonconforming), avoidance of,

xx

Thioridazine,

52

Title VII,

348, 349.See also Patient Protection and Affordable Care Act

TNG. See Transgender, non-binary, and/or gender diverse

gender-expansive people,

xix

Transgender, non-binary, and/or gender diverse/expansive (TNG) people,

xx–xxi.See also Disabled TNG people; Incarceration; Trauma-informed mental health care with TNG communities

abuse by law enforcement,

274

anti-TNG political groups,

18

argots,

314

barriers to care for,

77–78

Black adults,

5

in a cisheteronormative society,

49

coming out,

358

definition of,

xx–xxi

in DSM-III,

299

eating disorders and body image satisfaction in

overview,

215

terminology,

215

epidemiological overview of mental health outcomes,

1–2

focus groups and,

358

homelessness,

236

ICD-11 classification of TNG as a “condition related to sexual health,”

299

identification documents for,

351–353

intimate partner violence,

236

jargon,

314

“legitimately transgender,”

145

marginalization of,

155

negative stance against,

xxi–xxii

outing,

317

quality of life of,

2

refusal of medical care to,

223

resilience among,

2

risk of eating disorders among,

216

risk of suicidality among,

7

role models,

195

role of community strengths, resilience, and cultural continuity,

78–79

safety of,

159–160

as sex workers,

236

slang,

314

social determinants of health for,

75–77

strengths of,

195

SUD rates among,

7

“transition” as perceived by society,

145

unemployment,

236

unequal treatment by law enforcement,

274

viewed as “non-normative,”

131

violence against,

85

vulnerabilities of,

154

Tobacco and other nicotine-based products,

55

as drug of abuse,

231, 233

prevalence in TNG communities,

232–233

vaping,

234

Topiramate,

55

Trans

acceptance of,

181

definition of,

xx

description of,

171

walking while trans,

274

Trans+, definition of,

xx

Trans broken arm syndrome,

92, 132, 216

Transference love,

175.See also Transphobic countertransference

Transgender, definition of,

310

Transgender and gender nonconforming, (TGNC), avoidance of,

xx

Transgender and non-binary (TGNB), definition of,

xx

Transgender Day of Remembrance,

356

Transgender Law Center,

145

Transhealth

.See also Clinicians; Community

development as a community health center,

359–361

“good partner” for,

361

as mental health model,

361

services at,

361

TNG people’s participation in,

360

Transhealth Gender-Affirming Care Access Program,

362

Transhealth Institutional Review Board,

362

“Transition,” as perceived by society,

145

Trans men

.See also Beatie, T.; Pregnancy

EHRs for,

253

legitimacy of,

20

quality of life among,

8

Transmisogynoir, description of,

86

Transmisogyny, experience of,

23

Transparent,

254

Transphobia

among TNG AAPI people,

103

as an “unresolved issue,”

173–174

definition of fear of TNG people, xxiix

description of,

173

medical,

133

physical abuse and,

76

Transphobic countertransference

neurotic,

179–181, 182

perverse defense and,

178, 179, 182

psychotic,

178, 182

Transphobic countertransference (TCT)

analytic third,

176

cisgender countertransferential enactments,

173

examples of,

177–182

history of,

174–177

neurotic, description of,

174

overview,

171–174

perverse, description of,

174

psychotic, definition of,

173–174

theories of,

173

Trans PULSE Canada study,

130

Transsexualism, classification in DSM-IV and DSM-IV-TR,

299

“Transsexuals,”

202

Transvestites,

312

Trans women

legitimacy of,

20

quality of life among,

8

Trauma

definition of,

155–156

exposure and victimization,

155

GAS and,

302–303

history of,

40

insidious/complex,

155–157

medical,

133, 302–303

medical care and mental health fare as sources of,

156–157

of migrants and immigrants,

142

from nontraumatic events,

302

role of historical and intergenerational trauma among Two-Spirit people,

73–75

Trauma Affect Regulation: Guide for Education and Therapy (TARGET),

280

Trauma and grief components therapy,

280

Trauma-informed mental health care with TNG communities

advocacy and community engagement,

163

anti-TNG bias and non-affirmation as insidious/complex trauma,

155–157

assessment/identification of trauma history,

161–162

clinician advocacy,

163

definition of,

157–159

diagnostic considerations,

161

four Rs of trauma-informed care,

158–159

impact on clinician,

163–164

importance of affirmation to reduce retraumatization and establish safety,

159–160

misdiagnosis,

161

overview,

153–154

principles of,

157–158

psychological distress and traumatic stress,

154–155

retraumatization resistance,

159

secondary traumatization and triggered responses,

163–164

treatment planning considerations,

162–163

treatment relationship considerations,

160–161

tripartite/triphasic model of trauma

therapy,

162–163

victimization and trauma exposure,

155

Traumatic stress,

154–155

Tribes

Elder’s role within,

78

membership in,

74

Tricyclic antidepressants, during the perioperative period,

62

Trump administration, xenophobic rhetoric toward Chinese and Chinese American populations during COVID-19 pandemic,

104

Turtle Island,

71.See also Two-Spirit people

Tuskegee Study of Untreated Syphilis in the Negro Male,

90

12-step programs, for treatment of SUDs,

241

2S. See Two-Spirit people

Two-Spirit (2S; 2SLGBTQIA+) people,

xxi

barriers to care for,

77–78

colonialism and,

73–75

creation of,

72

in cultural communities,

312

Elders’ role and,

78

fear of mistreatment by health care providers,

78

homelessness among,

76

incarceration of,

76–77

labeling of,

72

medical neglect of,

77–78

mental health of,

77

overview,

71–73

raised by boarding school survivors,

74

role of community strengths, resilience, and cultural continuity,

78–79

role of historical and intergenerational trauma in,

73–75

social determinants of health for,

75–77

sociocultural context of,

72

suicide attempts of,

77

Two-Spirit (2S; 2SLGBTQIA+) people,

xxi

health outcomes among,

252

interdisciplinary care for,

206

for youth,

188

2TNG people

clinicians,

172

description of,

171

discrimination against,

182

in DSM-III,

179

Umoja, S.,

220

United Nations High Commissioner for Refugees,

140, 144

U.S. Armed Forces,

313.See also Veterans, transgender

U.S. Department of Justice,

349–350

U.S. Food and Drug Administration (FDA)

approval of nicotine replacement therapy for tobacco use,

241

public health advisory for varenicline,

240

U.S. Supreme Court

.See also Legislation

legalization of same-sex contact,

273

U.S. Transgender Survey, 2015,

6, 17, 76, 77, 89, 102, 129, 130, 203, 293, 351

Valproic acid, during pregnancy,

255

Vaping, as drug of abuse,

234

Varenicline, for treatment of SUDs,

240

Venous thromboembolism (VTE), risk of,

56

Verlinden, J.,

249

Veterans, transgender,

6.See also U.S. Armed Forces

Veterans Health Administration,

234

Victimization

.See also Incarceration

among Black TNG people,

84–85

discrimination and,

18

as distal stressor,

17–19

“no femmes, no Asians,”

103

of transgender inmates,

277

trauma exposure and,

155

Violence

among Black TNG people,

84–85

among TNG youth,

188–189

discrimination and,

19

migration and,

140–141

by police,

118–119

Vitamin D,

52

Vivitrol, for treatment of SUDs,

240

Von Krafft-Ebing, R.,

289

VTE (venous thromboembolism), risk of,

56

Vyvanse, for ADHD symptom management,

116

Walking while trans,

274

War on Drugs,

86

Well-being

.See also Belongingness

of 2S and TNG people,

75–77

advocacy for,

257

MST and,

22–23

of older TNG adults,

201–202

of TNG youth,

189

Wellbutrin, for ADHD symptom management,

116

“Whataboutism,”

264

Wholeness, recognition of, in disability justice framework,

130

Williams v. Kincaid,

350, 351

Winnicott, D.,

177

Women

assigned FMAB,

234

descriptive characteristics of,

32

female athlete triad,

222

gendered legibility markers for,

220

incarceration of TNG women with cisgender men,

277

marginalization of Black women,

86

“thin ideal” of,

219

Women’s health center, as cisnormative,

xxii

World Professional Association for Transgender Health (WPATH),

57, 202, 279, 298

Standards of Care,

279, 313, 344

WPATH. See World Professional Association for Transgender Health

Xenophobia, of displaced people,

146

Youth, TNG

.See also Children; Gonadotropin-releasing hormone analogs/agonists; Puberty

adapting GMSR for,

187–190

expanding for younger patients,

188–190

intersectionality theory,

187–188

overview,

187

addressing gender minority stressors and resilience with psychosocial interventions,

191–195

facilitating emotional regulation,

194

fostering sources of resilience,

195

using exposure to address avoidance behaviors,

194–195

discrimination against,

191

doctor-patient relationship,

342

eating disorders in,

220

“externalizing behaviors” in,

114

family acceptance of,

190

GAHT in,

6

mental health inequities among,

186–187

overview,

185–186

parental rejection of,

19

participation in community’s ceremonial life,

79

prevalence of anxiety disorders in,

3

protective factors for,

189–190

puberty blockers in,

50–51

socially transitioned trans youth,

131

stress and resilience among their

families and,

190–191

2SLGBTQIA+ communities and,

188

understanding minority stress,

192–193

verbal victimization of,

191

violence and,

188–189

working with families of,

195–196

Youth Risk Behavior Survey (YRBS), 2017,

6, 186, 188

YRBS (Youth Risk Behavior Survey), 2017,

6, 186, 188

Ziprasidone,

52

Zolpidem, as drug of abuse,

234