Individuals who are categorized as transgender are whose gender identity does not align with their allocated gender with respect to natal sex. The phenomenon associated with the sexual orientation is viewed to be uncommon. However, with the attention provided to it by the media and scholars, it is perceived that most people are identifying with it when they are still young. Also, transgender individuals, mostly at the adolescent stage, have been poorly researched despite them having significant and unique psychological and medical needs (Olson et al., 2011). The case regarding Cassandra includes the struggles that face a young transgender individual in a society and family that does not fully appreciate her difference. The analysis puts into view three issues that are essential in treating Cassandra in regards to her sexual orientation. Three issues that I believe are essential for Cassandras case include psychosocial consideration, medical treatment, and regular monitoring during the transitioning process.
Studies indicate that the self-identification by people who associate themselves with the transgender sexual orientation does not always imply that they have mental issues (Olson et al., 2011). It is perceived that most of the young people who identify themselves as transgender are faced with mental health issues particularly when it comes to challenges regarding not conforming to the associated gender expression and identity. Some of the issues that result in mental health problems include rejection from family members, rejection from friends, abuse, trauma, aggravation, legal issues, inadequate housing in addition to educational issues. It is perceived that transgender individuals are likely to be exposed to verbal abuse, public humiliation, physical abuse, and financial discrimination (Olson et al., 2011). For the young people, the discrimination often occurs in school and at home. Studies indicate a correlation between an atypical gender identity during childhood and experiences regarding abuse and mental health issues for most young people (Olson et al., 2011). According to Cassandras case, she experiences difficulty at her home when it comes to her siblings and parents accepting the fact that she wants to transition from being a boy to a girl. Possibly, she faces a hard time in trying to relate with her family members in addition to expressing herself. Despite having a peer network that supports her uniqueness, it can be perceived that the relationship between her family members is strained and hence, possibly affecting her development as a young individual. It is perceived that the presence of such challenges may result in mental health issues such as depression, anxiety, low self-esteem, posttraumatic stress disorder, issues with the body image, and suicidal tendencies in addition to substance abuse. The basic assumption is that families tend to play a significant role in the lives of transgender individuals. Families provide a support system such that they protect and provide a barrier to the young people from negative consequences and uphold positive medical well-being. However, families that do not provide adequate support systems or reject their young individuals often result in poor medical and mental health conditions. As stated earlier, Cassandra does not adequate support from her family members; possibly due to the attitudes that they have regarding unusual gender identities. Furthermore, her siblings view it as a choice that she chooses to make and hence can easily switch back to being a normal boy. Such inadequate support may trigger the occurrence of mental health issues and hence call the need for adequate mental care for Cassandra. According to Olson et al. (2011), Family members go through their process of adjusting to a child's transgender identity and typically experience the following stages: denial/shock, anger/fear, grief, self-discovery, acceptance, and pride/advocacy. Families can obtain support from organizations such as Trans Youth Family Allies. Therefore, my duty to my client is to develop a psychosocial system that involves both Cassandra and her family members during her transition process such that the family is aware of her needs and provide adequate support to her. This may include the provision of counseling services and guidelines on how to accommodate my client.
Another issue includes medical intervention. The case analysis regarding Cassandra does not mention the presence of medical services which are quite crucial for individuals such as Cassandra who are experiencing the transition from one identity to another. It is perceived that the first step during therapy for young transgender individuals is to undergo the GID diagnosis which is performed by a mental health expert. The involvement of the GID diagnoses is viewed to be relevant in supporting individuals such that they experience a smooth transitioning process (Olson et al., 2010). Therefore, at the beginning of her treatment, Cassandras GID should be diagnosed to ensure that she obtains adequate medical treatment. Apart from the diagnosis, it is perceived that young individuals who are beginning their puberty should be given medication that hinders the development of the hormones of the undesired gender identity (Tishelman et al., 2015). Cassandra is fifteen years old which implies that she has already begun experiencing puberty changes. According to Tishelman et al. (2015), biological males with affirmed female identities may experience significant growth, permanent facial hair and vocal changes, and intolerable erections. A voice that has deepened cannot be raised through hormone therapy, and requires difficult and expensive speech therapy, to affect a higher voice. In other words, Cassandra will have to receive both speech and hormonal therapy for her to fully align with the female identity. She may also have to undergo surgery to modify the other physical parts of her body such as her sexual organs and breast development. As a professional working with Cassandra, it is my duty to inform her of all the issues associated with medications and ensure that she receives medical treatment as per her consent. According to the case study, Cassandra was caught selling Ritalin after students who bought it abused it by mixing it with alcohol. Cassandra is perceived not to show any remorse with the view that she is aware of the procedures that are associated with the transitional process; which will cost her and hence the need for making money through any means. There are programs that freely assist in the provision of hormonal therapy to individuals in the transgender community (Tishelman et al., 2015). Therefore, as my client, I would work with Cassandras parents and her to ensure that she accesses this services without much pressure on the associated funds.
Another issue includes regular monitoring during the transitioning process; it is perceived that young individuals engaging in cross-gender hormone therapy require continuous care. The care also includes evaluating impending medical complications in addition to assessing the success of the feminization or the masculinization (Olson et al., 2011). As per the case analysis, the target is feminization. Assuming that Cassandra has begun engaging in the cross-gender hormone therapy, as the medical care practitioner, I have to see her through the process and provide support whenever possible. It is advised to monitor patients for three months during their first year of therapy to ensure that the desired effects are maximized while the negative implications are minimized during the adjustment of the dosages. The patients are less monitored when their development is stable. As her caregiver, I have to ensure that she receives the desired results from the therapy while putting into consideration any mental health issue that might be affecting her. Olson et al. (2011) states, More frequent monitoring should be considered in patients who are younger or have medical or mental health conditions that might be exacerbated by cross-gender hormone use.
As stated earlier, the analysis puts into view three issues that are essential in treating Cassandra in regards to her sexual orientation. Three issues that I believe are essential for Cassandras case include psychosocial consideration, medical treatment, and regular monitoring during the transitioning process. The case regarding Cassandra includes the struggles that face a young transgender individual in a society and family that does not fully appreciate her difference and hence the need for adequate intervention strategies that may enable her experience a smooth transition.
Olson, J., Forbes, C., & Belzer, M. (2011) Management of the Transgender Adolescent. Arch Pediatric Adolescent Medicine. 2011;165 (2):171176. doi:10.1001/archpediatrics.2010.275.
Tishelman, A., Kaufman, R., Edwards-Leeper, L., Mandel, F., Shumer, D., & Spack, N. (2015). Serving transgender youth: Challenges, dilemmas, and clinical examples. Professional Psychology: Research and Practice, 46(1), 37-45. http://dx.doi.org/10.1037/a0037490
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