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Culturally Competent Care for the LGBT Community Case Study

  • Presenting Provider Name: Monica DeCicco
  • Presentation Date: 11.21.19
  • Patient Biological Gender: Female
  • Patient Age: 16
  • Race: White/Caucasian
  • Ethnicity: Not Hispanic/Latino

Topics to discuss/areas of concern:

Member is a transgender female to male. He has little community connection with the LBGT where he resides. He has no natural supports and no long-term permanency option.

Pertinent Medical History: No physical health issues

Diagnosis: PTSD

Psychiatric History:

(Age of first mental health contact, Past Diagnoses, History of self-harming behaviors or suicide attempts, etc.)

Details: Member has a long history of self-harm and SI. He was assessed for the SED Waiver in May 2016. He has been wrapped in services. In June 2018, member began making suicide statements and eventually attempted suicide by overdoes requiring a physical health hospital stay for two days in October 2018.

PRTF stays: 1.2.19- 4.30.19 Florence Crittenton

IP Stays: 1 IP in 2017, 4 IP in 2018

Medication summary:

  • Quetiapine 300mg
  • Magnesium 250mg BID
  • Hydroxyzine 25mg PRN up to 4 times daily
  • Escitalopram 20mg QD
  • Fluticasone 50mcg PRN
  • Cetirizine 10mg QD
  • Trazodone 50mg QD
  • Docusate Sodium 100mg BID
  • Multivitamin

Trauma History:

(Age of significant traumas and brief summary)

Details: Came into care at the age of 5 due to allegations of neglect and abuse from biological father.  There was an incident whereas biological father attempted to strangle Member’s sister.  Member and his sister eventually moved to great aunt and uncle who took custodianship of the children.  The great aunt and uncle struggled to manage member and his sister and they returned to foster care, dissolving the custodianship in October 2018 

Social History:

(Current living situation, employment status, pertinent legal history, level of education, relationship status, children, support system, etc.)

Details: Member resides at a youth residential center in a semi-rural area of KS. He has not had any critical incidents since discharge from PRTF. He does have incidents of intense crying when triggered, being told no or disappointed. Member will start EMDR therapy to help manage behaviors.

He has some friendships but not extensive ones. He has done well educationally, and as a result he is able to attend an elective class at the regular high school. They are hoping to increase from one class if he is able to manage.

Pertinent Lab Work: n/a

Summary of recent Urine Toxicology (if applicable): n/a

Substance Use History, if applicable:

(For each relevant substance include age at first use, age where use became problematic/regular, longest period of sobriety (Including what how patient maintained sobriety) and most recent pattern of use.)

Member does not use substances.