Exploring the Needs, Expectations, and Realities of Mental Healthcare for Transgender Adults: A Grounded Theory Study on Experiences in Sweden

Sammanfattning: Transgender persons experience a disproportionate representation in adverse mental health conditions globally. In Sweden there are tangible efforts to improving mental healthcare overall, but as a minority population, transgender persons still struggle with meeting their mental healthcare needs. While social factors such as stigma and discrimination act as catalysts for this burden, there is an absence of understanding the role of mental healthcare for this population and how mental healthcare services are being utilized. The aim of this study was to gain an in-depth understanding of the mental healthcare needs for transgender persons in Sweden, that are both related and unrelated to the transition process. More specifically this study sought to explore the strategies employed by transgender persons to address their own concerns of mental health issues and mental healthcare. This gives insight into the role of mental healthcare and the ways care was navigated by trans persons. Nine in-depth, semi-structured interviews were conducted with persons who identified as transgender or gender non-binary, over the age of 18, at some stage of transition in Sweden. Data was collected, analyzed, and interpreted using constructivist ground theory. Three categories emerged from the analysis of the data, Objectification vs. Subjectivity, Constructing the Narrative, and Reflections of Care that illustrate the dual tensions at play in transgender visibility, communication with mental healthcare professionals, and expectations of care. Six subcategories further delineate the specific forces at work in tension with one another that construct the mental healthcare experiences for trans persons. Increased knowledge and visibility of transgender persons is needed to adequately serve the mental healthcare needs for this population. Currently there are barriers that inhibit transgender persons from getting the mental healthcare assistance desired and needed, as they do not view the healthcare system as safe space within which to receive care. As steps are being taken to de-pathologize transgender identities, momentum should be continued to create space for trans persons in society that enables unencumbered mental health assistance.