Clinical Situation
In practice, I have encountered various patients presenting with various psychiatric issues. One of the experiences that I would like to reflect on was this encounter I had with a 13-year-old boy who had what we later came to acknowledge as a gender identity issue. The clinical situation involves a 13-year-old boy named P.M. (not his real initials due to confidentiality issues), who was referred for a psychiatric review by his school counselor around one week ago. The school counselor, in her report, expressed concerns that P.M. was having episodes of depression and anxiety. During the assessment, P.M. expressed concerns that he was not feeling comfortable being identified as male and feels more comfortable being around females and acting like them. This, however, has raised significant concerns in the mother and some boys at school, who avoid him. This has caused him significant emotional distress, making him stressed most of the time. Prior to this clinical experience, I had prejudices, especially in matters of sensitivity, such as discussing sexuality with an adolescent. I also had assumptions regarding gender norms, which, if I had not addressed them properly, could have influenced my interaction with the boy.
Manage Your Anxieties, Feelings, Prejudices, and Biases
To manage my feelings, biases, and prejudices, I reminded myself that as a healthcare provider, I should attend to all patients without being judgmental of their situation. Additionally, I reminded myself of the need to create a safe space and supportive environment for P.M. to enable him to express himself and explore his feelings. I also acknowledged the need to be more aware of gender identity to ensure I provide affirming and respectful care to the patient. This will enhance their trust in me and contribute to openness regarding the situation (Rafferty et al., 2018).
Assumptions about People with Mental Illness
Initially, I had the assumption that individuals with mental illness, especially regarding gender identity issues, for instance, assume that all affected children and adolescents have families who support their gender identity or sexual orientation. I also had the assumption that children and adolescents are not developmentally capable of understanding or discussing complex topics like sexuality or gender identity. I also had the assumption that individuals with gender identity issues are comfortable disclosing their gender identity to healthcare providers. However, this is not the case, as some fear discrimination and stigma, hence the need to create a safe space and supportive environment for them to open up (Turban & Ehrensaft, 2018).
Awareness Developed
I developed several awareness from the clinical experience, for instance, the various biases and prejudices I had and the impact that they can have on my interactions with individuals with gender identity issues. I also gained insight regarding my various assumptions about individuals facing various mental health illnesses, such as gender identity issues, and the need to reflect and challenge such assumptions in practice continuously.
Changes Due To Clinical Experience
The clinical experiences resulted in significant changes; for instance, it has changed my approach when caring for individuals with gender identity issues, as I have acknowledged the need to be at the forefront in providing a safe space and supportive environment to foster the free expression of the patient on their concerns. Through the clinical experience, I would incorporate more comprehensive assessments of gender identity and expression into my practice and advocate for policies and practices that promote gender diversity and inclusion.
Impact on Advanced Nursing Practice
The clinical situation would impact my advanced nursing practice. I would integrate the lessons learned from this clinical experience into my approach to caring for patients with various issues, such as gender identity issues. I would advocate for the training of healthcare providers to enhance their competency in providing holistic and non-judgmental care to such individuals, and lastly, actively engage in ongoing education and professional development in order to be more informed of the best strategies to care for individuals with gender identity issues to ensure they receive the required care and are not discriminated against (Rider et al., 2019).
References
Rafferty, J., Yogman, M., Baum, R., Gambon, T. B., Lavin, A., Mattson, G., … & Committee on Psychosocial Aspects of Child and Family Health. (2018). Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics, 142(4). https://publications.aap.org/ExternalLoginResponse.ashx?elpId=3&redirecturlback=http://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for?autologincheck=redirected&nfToken=00000000-0000-0000-0000-000000000000
Rider, G. N., McMorris, B. J., Gower, A. L., Coleman, E., Brown, C., & Eisenberg, M. E. (2019). Perspectives from nurses and physicians on training needs and comfort working with transgender and gender-diverse youth. Journal of Pediatric Health Care, 33(4), 379-385. https://www.sciencedirect.com/science/article/pii/S0891524518304474
Turban, J. L., & Ehrensaft, D. (2018). Research review: Gender identity in youth: treatment paradigms and controversies. Journal of Child Psychology and Psychiatry, 59(12), 1228-1243. https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.12833
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