DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS The International Society of Psychiatric-Mental Health Nurses formally endorses gender-affirming care as essential mental health practice, citing 43–52% of TGD youth considered suicide in the past year. More than 230,000 transgender youth now live in states that ban or restrict access to gender-affirming care.
Professional Impact
- Family rejection is a well-established suicide risk factor; family support is cited as a critical protective factor for TGD youth.
- TGD patients frequently delay mental health care due to fear of harassment: discriminatory care directly worsens outcomes.
- 24 states have passed restrictions on gender-affirming treatments, creating legal and ethical complexity for nurses in affected states.
- ISPN calls for universal mental health screening, affirming name and pronoun use, and inclusive intake processes across all care settings.
Action Items
- Use patients’ preferred names and pronouns in all documentation and direct care interactions.
- Screen all TGD youth for suicidality and depression using standardized, validated tools.
- Document family support status: rejection or acceptance is a key suicide risk and protective factor.
- Connect TGD patients and families with the Trevor Project and other affirming community resources.
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