The following article is a part of conference coverage from the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30 to October 4, 2020. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading nurses in psychiatry. Check back for more from APNA 2020.


Psychiatric-mental health nurse practitioners (PMHNPs) have the opportunity to advocate for gender-affirming hormone therapy (GAHT) to alleviate depressive symptoms in transgender patients, according to research presented at the American Psychiatric Nurses Association 2020 Annual Meeting, held online from September 30th to October 4th, 2020.

Jack O’Connor, RN, BSN, of the University of Rochester School of Nursing, conducted a literature review that included 7 studies (3 systematic reviews, 1 cross-sectional study, 1 longitudinal case series, 1 prospective longitudinal study, and 1 hybrid cross-sectional/longitudinal study), to establish the prevalence of depression and dysphoria in transgender individuals. The latest version of standards of care issued by the World Professional Association for Transgender Health (WPATH, SOC7) was used to determine the ability of practitioners to advocate for GAHT for transgender clients and the accessibility of patients to gender-affirming care.

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Between one-third and one-half of transgender persons have experienced depression at least once during their lifetime, and as many as one-half have attempted suicide. A nationwide survey shows that 85% of transgender persons have received or desire to receive GAHT. The literature offered evidence to support that GAHT is associated with a decrease in depressive symptoms in individuals with gender dysphoria.

“The findings of this literature review and the objectives of this project have direct implications for the PMHNP role by relating to several core and PMHNP specific competencies as outlined by the National Organization of Nurse Practitioner Faculties (NONPF),” the study author concluded. “Although the NONPF does not specifically mention gender or transgender in its NP core or PMHNP specific competencies, it is important for the PMHNP to be sensitive to the cultural issues influencing the client’s presentation, including gender.”

According to the researcher, in the case that a transgender client presents to a PMHNP to seek an evaluation to receive a letter in support of obtaining GAHT, these results empower the NP to advise on GAHT and its effects on dysphoria and depression.

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O’Connor J. Depression and gender affirming hormone therapy: nurse practitioners as advocates for transgender clients. Presented at: APNA 34th Annual Conference; September 30-October 4, 2020. Poster 94.