Gender Issues Faced by Psychiatric-Mental Health Nurses


Working with children and adolescents who consider themselves as gender non-conforming (GN) or transgender, psychiatric-mental health nurse practitioners (PMHNPs) need to pay attention to certain issues to address. The problem is that being gender non-conforming or transgender can cause many troubles for youth, and PMHNPs should be aware of all these issues while working with these patients. The purpose of this paper is to identify the major issues faced by PMHNPs in this context, provide the rationale for the discussed aspects, and analyze implications for nurses’ practice.

Identification of Major Issues

The key issue to be aware of when working with GN and transgender youth is associated with determining the nature of possible gender dysphoria. Another issue is the selection of a strategy to cope with those children and adolescents who can be described as gender non-conforming or transgender (Olson, Durwood, DeMeules, & McLaughlin, 2016). One more issue is associated with focusing on the necessity of prescribing the puberty-blocking intervention as an approach to helping a young person to decide on a gender to choose (Tishelman et al., 2015). These issues are described in the existing scholarly literature in detail, and the rationale needs to be presented.

Rationale for Issues

Firstly, while starting their work with a GN or transgender young person, PMHNPs need to determine what kind of a gender identity problem is observed and whether this case can be regarded as gender dysphoria. Problems with identifying the gender and conforming to it can be a result of another psychological or psychiatric issue, or they can be indicators of actual gender dysphoria (Vance, Ehrensaft, & Rosenthal, 2014). Thus, approaches to addressing these problems are different, and PMHNPs are usually challenged to conduct several assessments to decide on the nature of a patient’s state.

The selection of a strategy appropriate for addressing the problem is another issue to discuss because nurses often face obstacles while deciding on how to cope with children’s gender dysphoria. Issues can be related to determining whether these children and adolescents should disclose their problem as early as possible, take hormonal therapy, or try to conform to the assigned gender (Ehrensaft, 2017; Olson et al., 2016). The rationale for determining the third issue is that puberty-blocking or hormonal interventions can have unexpected effects on patients leading to both physical and psychological problems.

Implications for Practice

The major implications of the determining issues for PMHNPs should be analyzed in detail. PMHNPs are expected to demonstrate their professional skills in assessing young persons’ state to determine the authenticity of the gender-related problem that affects the quality of the overall treatment (Tishelman et al., 2015). Secondly, PMHNPs are responsible for selecting interventions depending on the conducted assessments to address gender nonconformity (Vance et al., 2014). If assessments are not credible, psychotherapy, medical interventions, and the cooperation with a family can be ineffective. The prescription of medical interventions for GN and transgender youth is a challenging task for PMHNPs because children’s psychological readiness should be clearly determined.


Those children and adolescents who can be described as gender non-conforming and transgender usually require the professional assistance of PMHNPs. However, much attention should be paid to certain issues that influence the quality of communication between a young person and a PMHNP, as well as the quality of treatment. The determination of these issues and barriers is important to help PMHNPs identify certain implications to address in their practice and increase the quality of provided care.


Ehrensaft, D. (2017). Gender nonconforming youth: Current perspectives. Adolescent Health, Medicine and Therapeutics, 8, 57-67. Web.

Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), 1-10. Web.

Tishelman, A. C., Kaufman, R., Edwards-Leeper, L., Mandel, F. H., Shumer, D. E., & Spack, N. P. (2015). Serving transgender youth: Challenges, dilemmas, and clinical examples. Professional Psychology: Research and Practice, 46(1), 37-45. Web.

Vance, S. R., Ehrensaft, D., & Rosenthal, S. M. (2014). Psychological and medical care of gender nonconforming youth. Pediatrics, 134(6), 1184-1192. Web.