Gender Dysphoria Assignment Essay

NRNP 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent

Week 11

Introduction Resources Discussion Assignment Making Connections My Progress Tracker

NRNP 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent Gender Dysphoria Assignment Essay

Week 11: Special Topics in Child and Adolescent Psychiatry

\”Here we go again; another foster home. My father kicked me out when he saw me wearing Mom’s clothes. He did not understand that deep down, I know that I am a girl. My birth certificate may say male, but it is wrong. I feel so much better being myself… being a girl. Maybe this foster family will understand and accept me for who I am, or I am just going to run away again.\”

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Joseph/Josephine, age 16

In your practice as a PMHNP, you may see many children and adolescents who are faced with challenges that go beyond the standard DSM-5 diagnoses. Children in foster homes or who have been adopted may have emotional scars from previous abuse or neglect; adolescents experiencing issues with gender dysphoria may be faced with peer and family issues; and children involved in acts of terrorism may face reoccurring fear and mistrust.

This week, you explore psychological issues that may arise in children faced with special circumstances and the assessment and treatment options specific to these special populations. You also take your final exam for the course.

Learning Resources

Required Readings

American Academy of Child & Adolescent Psychiatry (AACAP). (2012c). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 51(9), 957–974. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00500-X/pdf Gender Dysphoria Assignment Essay

American Academy of Child & Adolescent Psychiatry (AACAP). (2011). Practice parameter for child and adolescent forensic evaluations. Journal of the American Academy of Child & Adolescent Psychiatry, 50(12), 1299-1312. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00883-5/pdf

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standards 11 “Communication” (page 75)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Somatic Symptom and Related Disorders”

“Other Conditions That May Be a Focus of Clinical Attention”

“Assessment Measures”

“Cultural Formulation”

Human Rights Campaign. (n.d.). Growing up LGBT in America. Retrieved June 8, 2017, from http://assets.hrc.org//files/assets/resources/Growing-Up-LGBT-in-America_Report.pdf?_ga=1.83582870.1279387255.1493224749

Lee, T., Fouras, G., & Brown, R. (2015). Practice parameter for the assessment and management of youth involved with the child welfare system. Journal of the American Academy of Child & Adolescent Psychiatry, 54(6), 502–517. Retrieved from http://www.jaacap.com/article/S0890-8567(15)00148-3/pdf

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 31, “Child Psychiatry” (pp. 1279–1323)

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Disorders” (pp. 239–249)

Chapter 49, “Forensic Psychology” (pp. 636–647)

Discussion: Special Topics in Child and Adolescent Psychiatry

Many children face special issues that impact everyday life, whether it is within themselves, their families, or their environment. The PMHNP must be sensitive to these many issues that children and adolescents are faced with during important developmental years.

In this Discussion, you select a special population and analyze the psychological issues that the population faces. You also address the assessment and treatment needs of the population. Gender Dysphoria Assignment Essay

Learning Objectives

Students will:

Analyze psychological issues that may arise in children faced with special circumstances

Evaluate assessment measures used with children faced with special circumstances

Evaluate treatment options used with children faced with special circumstances

Analyze cultural influences on treatments (D)

To Prepare for the Discussion:

Review the Learning Resources.

Select one of the following topics for the Discussion:

Adoption

Foster care

Gender dysphoria

Forensic issues

Impact of terrorism on children

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

Write your selected disorder in the subject line of your Discussion post.

Explain the psychological issues that may result from your topic.

Describe the most effective assessment measure that could be used, and explain why you selected this.

Explain the treatment options available for children and adolescents involved with your selected disorder.

Explain how culture may influence treatment.

PLEASE NOTE THAT I HAVE CHOSEN\” GENDER DYSPHORIA\

Childhood gender dysphoria is a major public health problem with detrimental effects not only to an individual but to the society. Children with a history of gender dysphoria are likely to suffer psychological issues that affect their functioning. Numerous studies such as Fuss et al. (2015) have associated childhood gender dysphoria with adverse mental health issues such as depression, anxiety, and suicide behaviors. Dysphoria can also lead to substantial educational behavioral issues. Understanding and assessing children at risk of developing psychological issues is critical in delivering quality care. This paper outlines the various psychological issues associated with childhood gender trauma, its assessment, treatment modalities, and how culture affects treatment.Gender Dysphoria Assignment Essay

Psychological Issues in Children with Special Circumstances

Children who have gender dysphoria continue to have psychological issues such as suicide ideation, suicide attempts, and substance-related disorders. After their gender translation, suicide risk may persist or dissipate depending on how well they can adjust (Petterson et al., 2016). The children may also demonstrate coexisting separation anxiety disorder, generalized anxiety disorder, or depressive symptoms. According to Colizzi et al. (2015), social stigma has been implicated in most of the mental issues experienced by such children. Further, as they grow and adjust to life situations, the children are constantly faced with distress, rejection, and discrimination. Subsequently, they may harbor negative feelings towards their minority groups.

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Despite the widespread discrimination and their mechanism to cope with distress, such children also suffer cyberbullying, harassment and violence. Specifically, transgender children are at a higher risk of experiencing depressive and anxiety symptoms stemming from their perception of distressing situations (Petterson et al., 2016). Recent studies have indicated that emotional dysregulation during their trauma and abuse results in depressive symptoms as they attempt to adjust to new locations and situations (Petterson et al., 2016). The adverse effects of childhood gender dysphoria on emotional regulation results in the manifestation of psychological issues during their late childhood.

Moreover, the children suffer interpersonal relationship problems. Such experiences have a negative influence on how children initiate and maintain a relationship in the future. Their interpersonal functioning diminishes as they lean towards lacking trust towards people (Colizzi et al., 2015). The children are likely to become introverts as their social life diminishes. As they approach young adulthood, where they are expected to socialize and interact with their peers, they often have dysfunctional relationships that lead to stigma, isolation, and withdrawal from people.

Assessment

Without a proper assessment, the children can be transferred from one foster care or rehabilitation center to another without any positive clinical outcome. The diagnosis and treatment of childhood abuse are complex and a multidisciplinary approach should be assumed to ensure quality care to the child and their family (Ristori & Steensma, 2016). Although there is no screening strategy or a framework for such psychological cases, documentation of patient history provides insights into the cause of the psychological problems.Gender Dysphoria Assignment Essay

Documenting the history of the child goes beyond asking their parents and caregivers circumstances surrounding their suspicious injury. The nurse should assess the child’s medical, social and developmental history. The documentation of such variables should take place early in the diagnosis to serve legal and medical roles (Ristori & Steensma, 2016). The history should be obtained in a non-accusatory manner with critical features such as intentional trauma elicited. A comprehensive history should encompass components such as a family history of bone, metabolic or genetic disorders, pregnancy history and whether it was planned or unplanned, familial discipline patterns, and medical histories such as trauma and hospitalizations.

Treatment Options

One of the treatment options that can be explored for children with a history of gender dysphoria includes detoxification and withdrawal management. Medical detox is suggested to provide a safe and supportive environment that enables the patient to heal from their medical issues. Specifically, vulnerable patients require a supportive environment that encourages them to open up and receive supportive care (Ristori & Steensma, 2016).

Rehabilitation and behavior modification is another treatment option that can be explored. Such children never confront their history without reliving it and letting it run their lives. Behavioral rehabilitation allows the child to work with a mental expert and address the trauma-related symptoms (Ristori & Steensma, 2016). Usually, the therapist identifies their trauma root causes and sustaining factors enhancing faster remission. Techniques such as group therapy and individualized counseling can be carried out to supplement conventional therapies such as cognitive-behavioral therapy.

How Culture may Affect Treatment

The interplay of cultural factors and gender definitions makes it difficult to offer effective therapy to victims. Each society has its definition of sex and sexuality and this influences treatment adherence (Bonifacio et al., 2019). However, it is important to embrace cultural awareness and diversity to ensure the achievement of patient care goals. For instance, some cultures allow transgender which may be disregarded in other cultures.

Conclusion

Many children who suffer from gender dysphoria are at risk of suicide behavior, anxiety, depression, and interpersonal relationship problems. The lack of quality assessment and management leads to poor clinical outcomes. However, effective treatment methods such as individualized counseling can be used to supplement conventional therapy techniques such as cognitive-behavioral therapy.Gender Dysphoria Assignment Essay

References

Bonifacio, J. H., Maser, C., Stadelman, K., & Palmert, M. (2019). Management of gender dysphoria in adolescents in primary care. Canadian Medical Association Journal, 191(3), E69-E75. https://doi.org/10.1503/cmaj.180672

Colizzi, M., Costa, R., & Todarello, O. (2015). Dissociative symptoms in individuals with gender dysphoria: Is the elevated prevalence real? Psychiatry Research, 226(1), 173-180. https://doi.org/10.1016/j.psychres.2014.12.045

Fuss, J., Auer, M. K., & Briken, P. (2015). Gender dysphoria in children and adolescents. Current Opinion in Psychiatry, 28(6), 430-434. https://doi.org/10.1097/yco.0000000000000203

Petterson, L. J., VanderLaan, D. P., & Vasey, P. L. (2016). Sex, sexual orientation, gender Atypicality, and indicators of depression and anxiety in childhood and adulthood. Archives of Sexual Behavior, 46(5), 1383-1392. https://doi.org/10.1007/s10508-016-0690-x

Ristori, J., & Steensma, T. D. (2016). Gender dysphoria in childhood. International Review of Psychiatry, 28(1), 13-20. https://doi.org/10.3109/09540261.2015.1115754

Gender Dysphoria Assignment Essay