Exploring the Needs, Expectations, and Realities of Mental Healthcare for Transgender Adults: A Grounded Theory Study on Experiences in Sweden.

Purpose: Transgender persons experience a disproportionate representation in adverse mental health conditions globally. In Sweden, there are tangible efforts to improve mental healthcare overall, but transgender persons still struggle with meeting their mental healthcare needs and there is an absence of understanding the role of mental healthcare for this population and how services are being utilized. Thus, the aim of this study was to gain knowledge from transgender individuals in Sweden concerning their mental healthcare, their needs, expectations, and realities, regardless of transition status. Methods: Eleven in-depth interviews were conducted with persons who identified as transgender, older than 18 years, at some stage of transition in Sweden. Data were collected, analyzed, and interpreted using constructivist ground theory. Results: Three categories emerged from the analysis, Feeling Objectification Rather than Subjectivity, Constructing the Narrative, and Reflecting on Aspects of Care that illustrate the dual tensions at play in transgender visibility, communication with mental healthcare professionals, and expectations of care. Six subcategories further delineate the specific forces at work that construct the mental healthcare experiences for trans persons. Conclusion: Increased knowledge and visibility of transgender persons are needed to adequately serve the mental healthcare needs for this population. Currently, there are barriers that inhibit transgender persons from getting the mental healthcare assistance desired and needed, as they do not view the healthcare system as safe space. As steps are being taken to depathologize transgender identities, momentum should be continued to create space for trans persons that enables unencumbered mental health assistance.