SHM Converge Scientific Abstract ePoster Gallery-Intersectional Considerations in Acute Inpatient Pain Management for a Transgender Patient With Sickle Cell Disease

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This case report describes a 21-year-old transgender woman with sickle cell disease (SCD) who was hospitalized for an acute vaso-occlusive pain episode. Her history included tobacco use, depression, limited social support, and inconsistent follow-up with both hematology and gender-affirming care (GAC) services.<br /><br />During admission, the team used narrative interviewing (NI) and trauma-informed care (TIC) to better understand the patient’s priorities, build trust, and support shared decision-making. This approach clarified treatment goals and helped guide discussion of hormone therapy in the setting of elevated thromboembolic risk. The patient’s engagement and trust improved as a result.<br /><br />The report highlights broader concerns for transgender patients with SCD. National data suggest they experience worse outcomes than cisgender patients, including higher inpatient mortality and longer hospital stays. These disparities likely reflect pain-related stigma, trauma exposure, fragmented care, and multiple layers of social and medical marginalization.<br /><br />The authors argue that coordinated, multidisciplinary care is especially important for this population. Hospital medicine physicians are in a strong position to connect hematology, GAC, and other specialties during acute admissions. NI and TIC can help strengthen relationships, reduce mistrust, and support continuity of care.<br /><br />Overall, the case illustrates how intersectional, patient-centered approaches can improve acute inpatient pain management for transgender patients with SCD. The authors emphasize that the overlap of SCD, GAC, and transition from pediatric to adult care remains underexplored, and further research is needed to develop better clinical frameworks for this group.

Asset Subtitle

Stephen Y. Agyepong

Meta Tag

Author List Khaalisha Ajala, Stephen Y. Agyepong, TaRessa Wills

Category Clinical Vignettes

Concept Transgender Patients

Concept Sickle Cell Disease

Concept Vaso-occlusive Pain

Concept Gender-Affirming Medical Therapy

Concept Inpatient Pain Management

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine

Presenting Author Stephen Y. Agyepong

Track Adult

Keywords

sickle cell disease

transgender woman

vaso-occlusive pain

narrative interviewing

trauma-informed care

gender-affirming care

inpatient hospitalization

thromboembolic risk

multidisciplinary care

health disparities

Transgender Patients

Sickle Cell Disease

Vaso-occlusive Pain

Gender-Affirming Medical Therapy

Inpatient Pain Management