Donya Ahmadian*, Jessica Avila*, Trisha Patel*, Sogand Solgi*, Marcos Rocha*
* American University of the Caribbean School of Medicine

A 22 year old transgender man was voluntarily admitted to an inpatient psychiatric unit on 05/04/21 due to increasing anxiety, depression, and suicidal ideation with a plan. The patient has a history psychiatric hospitalization and previous suicide attempts. Prior diagnoses include bipolar disorder, attention deficit disorder (ADD), schizoaffective disorder, post-traumatic stress disorder (PTSD), schizophrenia, and seizures”. The patient had undergone treatment for gender reassignment but stopped medications due to undisclosed recent medical illness that included thrombocytopenia and splenectomy. Family history is positive for extensive emotional, physical, and sexual abuse. His brother is diagnosed with schizophrenia and his father has been diagnosed with bipolar disorder. Patient reports having a strained relationship with his parents and maternal grandmother and is currently homeless. Mental status on admission shows depressed mood and appears to have intact cognitive functioning. He is prescribed Lithium 900mg and Quetiapine 400mg daily for his bipolar disorder. He was hospitalized for 6 days and discharged but worsened and was re-hospitalized. He was released from hospital care on 06/15/21 and is being followed up upon in outpatient status. Transgender people are higher risk for major depression, PTSD, and substance use disorders. They are 4x more likely to have mental health challenges compared to cisgender individuals and 40% have attempted suicide at some point. People with severe mental illness (SMI) are often victimized and discriminated against. Transgender people with SMI experience a severe mix of vulnerabilities and societal reactions, placing them at high risk of misdiagnosis and adverse outcomes, often requiring specialized care.