Citation

Ceccolini CJ, Green JB, Friedman-Yakoobian MS. Early Interv. Psychiatry 2024; 18(3): 207-216.

Copyright

(Copyright © 2024, John Wiley and Sons)

DOI

10.1111/eip.13456

PMID

37463844

Abstract

INTRODUCTION: Although research has documented the marked disparities in rates of psychosis-spectrum diagnoses in various socially marginalized populations, there is limited research addressing the needs of gender expansive individuals in the context of psychosis-spectrum illnesses using a minority stress lens. As clinical high-risk for psychosis (CHR-p) assessment and treatment becomes accessible to increasingly diverse populations, there is a need for clinicians to demonstrate greater clinical competency working with individuals across diverse social backgrounds and identities.

METHODS: We examined rates of gender expansive (GE) patients seeking evaluation at an urban-based CHR-p clinic and compared the diagnostic profile of GE individuals to cisgender patients. Post-hoc analyses were conducted on clinical variables with significant differences between the cisgender and GE groups.

RESULTS: The proportion of GE patients seeking evaluation increased from 2017 (9.3%) to 2021 (16.7%). Compared to cisgender youth, GE patients had significantly higher depressive, social anxiety, borderline personality disorder symptoms, higher levels of suicidality and non-suicidal self-injurious behaviour, and lower role functioning. Gender identity was predictive of suicidality controlling for social anxiety, borderline symptoms, and role functioning.

CONCLUSIONS: We review implications for CHR-p treatment and discuss ways to integrate minority stress theory and gender-affirming practices into coordinated specialty care for CHR-p patients.

Language: en

Keywords

Adolescent; Female; Gender Identity; Gender-Affirming Care; Humans; LGBTQ health; Male; minority stress; psychosis-risk; Psychotic Disorders; Suicidal Ideation; Transgender Persons; transgender populations