GENDER SENSITIVE CARE – LEVEL 4

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CASE STUDY
Bert is 26 years old and was assigned female at birth. He now identifies as
transgender male and has done so since he was 15 years old. Bert is cared
for on a male in-patient ward within a psychiatric hospital. He was admitted
to the hospital at the age of 14.
Physical health – Bert has type 2 diabetes and a high body max index. He is
not on any medication for his diabetes but has been told he may need to
take oral medication if his weight continues to increase. Bert is also prone
to urinary tract infections. He menstruates each month and he requests
regular PRN pain relief due to painful cramps.
Mental Health – Bert has been diagnosed with a mixed personality disorder
and depression. Ward staff feel he demonstrates some traits of autism
although this has not been formally diagnosed. When Bert’s mental health is
poor, his behaviour deteriorates on the ward. He has previously assaulted
staff and other patients. He states this is because some of the patients
‘laugh’ at him and call him a ‘lesbian’. He is prescribed anti-depressants to
help regulate his mental health.
Well-being – In general, Bert is usually settled on the ward and has
developed close friendships with many of the other male patients. More
recently, Bert has confided to staff that he would like to grow his hair
longer and wear makeup although he continues to want to be identified as
male. Staff have been unsure on how to support Bert with these
requests. Bert has also confided to staff that he has sexual feelings for
another patient on the same ward.
Social Background – Bert is the younger of 2 children. His older brother
has a successful career in finance and is engaged to be married. His parents
divorced when he was 2 years old and have no contact with each other. His
mother is a teacher and his father was a social worker. His father is no
longer able to work as he has depression and anxiety which impacts greatly
on his own mental health. Bert has a relationship with both parents although
his father admits to struggling with his son’s gender identity. Bert was
raised in a middle class rural area and achieved average grades at
school. His teachers felt he could achieve more, but did not try hard
enough. Bert feels he was never as intelligent as his older brother.

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