Evidence map›Paper›PMID 39206720›Full record

ArticleJournal of advanced nursing2025

Social-ecological barriers and facilitators to seeking inpatient psychiatric care among transgender and nonbinary people: A qualitative descriptive study.

Ava J Boutilier, Kristen D Clark, Jordon D Bosse, Kasey B Jackman, Jaylyn Jewell, Carol Dawson-Rose

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In one paragraph

Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ava J BoutilierSchool of Medicine, Queens University, Kingston, Ontario, Canada.ORCID https://orcid.org/0000-0001-6307-9463
Kristen D ClarkDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0001-6584-4560
Jordon D BosseCollege of Nursing, University of Rhode Island, South Kingstown, Rhode Island, USA.ORCID https://orcid.org/0000-0003-3547-9077
Kasey B JackmanSchool of Nursing, Columbia University, New York, New York, USA.
Jaylyn JewellCollege of Health and Human Services, Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA.
Carol Dawson-RoseDepartment of Community Health Systems, School of Nursing, University of California san Francisco, San Francisco, California, USA.

Funding

Evaluating the Feasibility and Acceptability of Mindful Self-Compassion Among Gender Minority Young AdultsK01AT012495 · NCCIH · UNIVERSITY OF RHODE ISLAND · PI Jordon D. Bosse · 2023 to 2026
$556k
NCCIH NIH HHS K01 AT012495
6 · The paper itself

Abstract

AIM(S): To assess barriers and facilitators to seeking inpatient psychiatric treatment among transgender and nonbinary people.

designQualitative interview study.

methodsSemi-structured interviews were conducted from March 2019 to June 2022 with transgender and nonbinary people admitted to an inpatient psychiatric hospital in the United States during the past 5 years. Data were analysed using thematic analysis and constructed within a modified social-ecological model of stigma. Standards for Reporting Qualitative Research were used for this study.

resultsParticipants (N = 15) described barriers and facilitators across all three social-ecological levels. i) Individual themes included distrust of the mental healthcare system, feeling unsafe, loss of autonomy, minimizing one's own mental health needs, and feelings of accountability to others. ii) Interpersonal themes included: lack of support for transgender/nonbinary identity, limited transgender/nonbinary knowledge among mental healthcare professionals, and allyship. iii) Structural themes included: carceral setting, financial costs, and availability of non-profit treatment options.

conclusionMulti-level themes were identified as barriers and facilitators to seeking inpatient psychiatric care for transgender and nonbinary people, providing opportunities among inpatient settings to improve care delivery and engagement. Greater health equity can be achieved by addressing barriers to care. IMPLICATIONS: Incorporating inclusive and affirming practices in inpatient psychiatric services presents an opportunity to reduce barriers to seeking care. IMPACT: The present study describes the experiences of transgender and nonbinary people as they determine whether to voluntarily seek inpatient psychiatric treatment. This perspective allows nurses, health systems, and policymakers to integrate transgender and nonbinary people's needs to improve healthcare delivery. PATIENT/PUBLIC CONTRIBUTION: Transgender and nonbinary participants were recruited in collaboration with community organizations. Members of the transgender and nonbinary community participated in study design development and analysis and were part of the study team.

Indexed as

Health Services AccessibilityInpatientsMental DisordersMental Health ServicesPatient Acceptance of Health CareTransgender PersonsAdultAgedFemaleHospitals, PsychiatricHumansMaleMiddle AgedQualitative ResearchSocial StigmaUnited Statesinequities in healthpsychiatric nursingquality of caretransgender persons

Identifiers

PMID39206720
PMCPMC11868451

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.