The following is a summary of “A formative evaluation to inform integration of psychiatric care with other gender-affirming care,” published in the July 2024 issue of Primary Care by Goetz et al.

Transgender, non-binary, and gender-expansive (TNG) individuals face disproportionately high rates of mental illness and encounter unique barriers to accessing psychiatric care. Integrating TNG-specific psychiatric care with other physical health services may enhance patient engagement. Yet, there is a paucity of published literature detailing patient and clinician perspectives on such integrated care models. This study aims to provide a formative evaluation to inform future initiatives to integrate psychiatric care with physical health care for individuals with TNG.

In this qualitative pre-implementation study, semi-structured interview guides were developed based on the Consolidated Framework for Implementation Research. This approach ensured consistent inclusion and sequencing of topics, enabling valid comparisons across interviews. Researchers gathered insights from patients with TNG (n=11) and gender-affirming care clinicians (n=10) to understand their needs and preferences regarding integrating psychiatric care with other gender-affirming clinical services. A rapid analysis procedure was conducted to provide a descriptive analysis for each participant group and identify challenges and opportunities in offering integrated gender-affirming psychiatric care.

The findings revealed a unanimous preference among participants for integrating psychiatry within primary care rather than utilizing siloed service models. Both patients with TNG and gender-affirming care clinicians expressed a strong preference for direct patient access to psychiatry appointments, as opposed to limiting psychiatrist consultations to the care team. Additionally, clinicians indicated a desire for increased access to psychiatric consultations. The importance of flexible, tailored care was a recurring theme. Key facilitators for successful integration identified by participants included accepting insurance, offering telehealth services, ensuring clinician competence in TNG-specific issues, and allocating protected time for clinicians to collaborate and seek consultations.

This health equity pre-implementation project actively engaged patients with TNG and gender-affirming care clinicians to inform future research on integrating mental health care with primary care for the TNG community. The findings suggest that such a model of care could be beneficial, highlighting the need for further exploration and implementation of integrated care approaches that address the specific needs and preferences of patients with TNG.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02472-8