Gender Diversity Assessment and Consultation Clinical Psychologist Service in WA Youth Mental Health

 

 

 

 

 

NMHS Youth Mental Health

Nicole Albrecht I Nicole.Albrecht@health.wa.gov.au

Key Learnings:

  1. Gain an increased understanding of innovative service development that increases capacity to meet the needs of gender diverse youth within the adult public health system.
  2. Demonstrate a collaborative care model that utilises community health services to provide gender-affirmative healthcare.

Transgender and gender diverse youth across Australia are at elevated risk of suicide, self-harm, homelessness, and other mental health and psychosocial difficulties (Strauss et al., 2017). Barriers to accessing gender affirmative care, including medical interventions, contribute to the distress experienced by this group of young people. Furthermore, negative experiences when accessing medical and mental health services contribute to experiences of discrimination and poor mental health outcomes (Strauss et al., 2017; Riggs et al., 2014). There is a need to increase the accessibility of care through the development of new services in addition to improvement and collaboration amongst existing services. The development of a new Gender Diversity Assessment and Consultation Clinical Psychologist Service within the North Metropolitan Health Service Mental Health’s Youth Mental Health, aims to increase accessibility of gender-affirmative health care within the WA public health system. 

For some gender diverse individuals having access to medical intervention/s to align one’s body with a one’s experienced gender is an important part of their gender journey. Medical transition in those who are seeking this care has been shown to improve psychosocial functioning and alleviate gender dysphoria (de Vries et al., 2014; Murad et al., 2010; Smith et al., 2005). A young person’s inability to access a specialist mental health assessment for gender affirming medical interventions can present as a barrier to accessing this care. In response to the recognition of a gap in service provision, a new service has been created to help meet the needs of Western Australia’s gender diverse youth. 

The Gender Diversity Assessment and Consultation Clinical Psychologist Service is a state-wide service that is open to gender diverse young people aged 17- 24 years old (inclusive). It serves young people who are seeking specialist assessment for gender affirming medical interventions (i.e. hormones and/or surgery) and who may also present with complex co-occurring issues or are unable to access these specialist services elsewhere. Assessment follows the standards of care guidelines set forth by the World Professional Association for Transgender Health. The service has capacity to provide a mental health assessment to ascertain readiness for gender affirming medical treatment. 

A multi-disciplinary approach to care is achieved via referral and collaboration with medical providers and services within both the public and private sector. The service also provides specialist consultation, training, community development, and referral information related to supporting gender diverse youth. The creation of this service aims to increase access to quality gender affirming care and increase capacity within existing services to improve the mental, social and physical health outcomes for gender diverse young people in Western Australia.

The service is a demonstration of how public community health services can work collaboratively to reduce barriers to care for transgender and gender diverse young people. NMHS MH Youth Mental Health services in WA have developed and maintained a commitment to holding a LGBTIQA+ Champion position in the community. This has included provision of knowledgeable, inclusive, and welcoming services for LGBTIQA+ young people, provision of LGBTIQA+ mental health training for staff and other service providers, and consultation across the youth sector. The addition of this specialist service is a demonstration of an innovative model of care which aims to provide gender-affirmative healthcare to those young people who may otherwise be unable to access this care. 

For WA Residents; referrals for assessment can be made by completing the Gender Diversity Assessment and Consultation Clinical Psychologist referral form and emailing this to youthmhtriage@health.wa.gov.au or contacting the WA Youth Mental Health triage line on 1300 362 569. 

References
de Vries, A., McGuire, J., Steensma, T., Wagenaar, E., Doreleijers, T., Cohen-Kettenis, P. (2014). Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment. PEDIATRICS: 134(4): 696-704
Murad M., Elamin M., Garcia .Z, Mullan R., Murad, A., Erwin, P., Montori, V. (2010). Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clinical Endocrinology, 72:214–231.
Riggs, D., Coleman, K., Due, C. (2014). Healthcare experiences of gender diverse Australians: A mixed-methods, self-report survey. BMC Public Health, 14:230.
Smith YL, Van Goozen SH, Kuiper AJ, Cohen-Kettenis PT. (2005). Sex Reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals. Psychological Medicine; 35(1):89–99.
Strauss, P., Cook, A., Winter, S., Watson, V., Wright Toussaint, D., Lin, A. (2017). Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results. Telethon Kids Institute, Perth, Australia.