California Requires Gender Pronouns

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Please re-assign if more suited in another thread. Thank you.

This Law, link below, was ratified in California. This law, as it appears to me, is an opening for many issues in a LTAC scenario. To Quote:

"The bill would require a violation of these provisions to be treated as a violation under the Long-Term Care, Health, Safety, and Security Act of 1973, the California Residential Care Facilities for the Elderly Act, or specified provisions providing for the licensure and regulation of health facilities, which may include the imposition of civil penalties. By expanding the definition of existing crimes, the bill would impose a state-mandated local program."

And,

"According to "Stories from the Field: LGBT Older Adults in Long-Term Care Facilities," a 2011 study published by the National Senior Citizens Law Center, these issues have gone unaddressed. In that study, 43 percent of respondents reported personally witnessing or experiencing instances of mistreatment of LGBT seniors in a long-term care facility, including all of the following: being refused admission or readmission, being abruptly discharged, verbal or physical harassment from staff, staff refusal to accept medical power of attorney from the resident's spouse or partner, discriminatory restrictions on visitation, and staff refusal to refer to a transgender resident by his or her preferred name or pronoun."

One of my concerns are the Patient identifiers we use before any medication or procedure. Say the Pt is giving a name as "Amy" but his/her name is "Andy" on the hospital band. Would this be considered a medication error? Are we then to perform HCG tests on all Pt. who identify as Female? Will insurance not want to pay us for using the incorrect pronouns in the nurse's notes? I'm worried about how far this rabbit hole will go.

I in my personal career use terms such as "Gal", "Bud", and "Bubby" (for children). I understand that these even are frowned on in the clinical setting, however I find that it increases the sense of moral with the Pt and Pt family when using this nomenclature.

I am interested to read all views, but am especially interested if nurses have seen this in action yet.

God Speed,

-David

Law text: Bill Text - SB-219 Long-term care facilities: rights of residents.

Specializes in Hospice.
So here's a guy who comes here asking a simple, honest question and he's getting a lambasting from you and elkpark.

Is it just human nature to fight over every thing?

OP, I'm sorry your motives were suspected. I hope you stick around and can get some answers.

I agree with you that no law would be necessary if there weren't the possibility for trouble to happen. What a mess human nature is.

How dare anyone have an opinion or experience different than anyone else here?

Once again, you and the OP are welcome to have any opinion that makes sense to you. The issue arises when that opinion is forcibly imposed on another in his/her own home. IE room assignments in ltc based on the OP's idea of gender identity rather than the resident's own. Or forcing a resident to dress according to the OP's notion of gender-appropriate attire rather than how the resident feels comfortable. This law is about way more than just pronouns. It's about emotional abuse.

The OP is whining about being held accountable if she forces trans residents to re-live - possibly for the rest of their lives - the same distress they experienced before they transitioned. Snowflakes, indeed.

Specializes in Critical care, tele, Medical-Surgical.

My step-Mom lives in a senior community with a SNF on the property. Twice after hospital discharge she was cared for at the SNF. For many that is their home. They also have a locked dementia unit with nice room and a patio where they can sit outside. When there is music at the SNF or a concert in the section where independent people live a companion HHA takes one or two of them.

Many of the independent residents use walkers and have medication service. One of the two LVNs on duty brings the medications as ordered by the physician, NP, or PA. That cost $150.00 a month in addition to the homeowners association fees.

One man, who just turned 80 recently, lost his long time lover after a falling and not ever waking up. When they had dances he would go in drag and dance with his partner. When dressed as a woman he uses a female name.

On the 28th there will be a Halloween party with grand children and great grandchildren coming. He plans on dressing up and handing out candy to kids. He is really excited. He showed my Step-Mom and I pictures of him in drag when he and his partner were young. He truly looked like a beautiful glamorous woman. Now he looks like a tacky, but nice old lady.

They have free transportation to doctor appointments, outings to movies, stores, and restaurants. One of the drivers is a youngish trans woman. I don't think most of the staff or residents know she was once a man. Somehow she knew it was OK to discuss it with her.

Step-Mom was with a woman for years before meeting and marrying my Dad. They loved each other and she was a good wife for my Dad 18 years before he died.

While I was at their house caring for him that lady called on the phone. She told me, "I used to be *****'s wife. She then describes the very attitudes and behaviors I was dealing with. You she lived with her. Things like being very upset when I was putting stamps on Christmas cards as she asked and ONE STAMP was crooked.

Anyway, that young driver is personable and helpful.

I don't notice anyone, staff or resident, being uncomfortable when a gay person or the driver joins in the Wednesday poker games, the mahjong, or backgammon. Some are cheerful and others are grumpy.

Once again, you and the OP are welcome to have any opinion that makes sense to you. The issue arises when that opinion is forcibly imposed on another in his/her own home. IE room assignments in ltc based on the OP's idea of gender identity rather than the resident's own. Or forcing a resident to dress according to the OP's notion of gender-appropriate attire rather than how the resident feels comfortable. This law is about way more than just pronouns. It's about emotional abuse.

The OP is whining about being held accountable if she forces trans residents to re-live - possibly for the rest of their lives - the same distress they experienced before they transitioned. Snowflakes, indeed.

Ah, now I begin to understand. Thanks for clarifying. No one else bothered. They just immediately jumped on a newcomer for being new and were suspicious of him for who knew what.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Ah, now I begin to understand. Thanks for clarifying. No one else bothered. They just immediately jumped on a newcomer for being new and were suspicious of him for who knew what.

Those of us who didn't bother assumed one would just know that trans people are victims of abuse all the time, and this law is meant to help protect them. We didn't think it was necessary to explain that, as we figured this is an obvious fact.

And fwiw, I think only one person "jumped on a newcomer for being new" - the rest of us simply took issue with his stunning lack of cultural sensitivity.

Ah, now I begin to understand. Thanks for clarifying. No one else bothered. They just immediately jumped on a newcomer for being new and were suspicious of him for who knew what.

Not "who knew what" -- I "jumped on" him for coming here with exactly the agenda he eventually disclosed.

The OP is whining about being held accountable if she forces trans residents to re-live - possibly for the rest of their lives - the same distress they experienced before they transitioned. Snowflakes, indeed.

Sorry all, been off. First of all, DaveRN is a man. A large man. A grizzly man if you will. But no beard, they itch.

Thanks to all for your heart felt responses. Both for and against. I did, among the cries of pot calling the kettle snowflake, get wonderful responses. I wish to re-iterate that I will care for anyone, anywhere in the best way I can. I will never let my own personal feelings come between the well being and safety of my patients. I have cared for and worked for all people and will continue to do so.

I thanks you all again for the responses and look forward to participating in many riveting discussions on Allnurses.

Specializes in Hospice.
The OP is whining about being held accountable if she forces trans residents to re-live - possibly for the rest of their lives - the same distress they experienced before they transitioned. Snowflakes, indeed.

Sorry all, been off. First of all, DaveRN is a man. A large man. A grizzly man if you will. But no beard, they itch.

QED

It's clearly important to you that your gender not be mis-stated, or your very first response would not have been to correct my (deliberate) reference to you as a female.

Now, imagine being referred to as a woman constantly, called by the wrong name and forced to dress and live as a woman in your own home (ltc).

It is abuse, pure and simple. And every single trans person in long-term care has experienced that abuse in their lifetimes.

Yet, a trans person wanting the same acknowledgement you expect as a matter of course, who demands that you refrain from repeating elements of past abuse, is somehow a snowflake determined to oppress you. SMDH

Sorry all, been off. First of all, DaveRN is a man. A large man. A grizzly man if you will. But no beard, they itch.

QED

It's clearly important to you that your gender not be mis-stated, or your very first response would not have been to correct my (deliberate) reference to you as a female.

Now, imagine being referred to as a woman constantly, called by the wrong name and forced to dress and live as a woman in your own home (ltc).

It is abuse, pure and simple. And every single trans person in long-term care has experienced that abuse in their lifetimes.

Yet, a trans person wanting the same acknowledgement you expect as a matter of course, who demands that you refrain from repeating elements of past abuse, is somehow a snowflake determined to oppress you. SMDH

So you admit to deliberately mis-gendering me to get a rise? Well now i need legislation to make sure I, as a minority in the nursing field, never have to be subjected to people like you and your kind!

Wait, no I don't. I'm a rational adult and can understand the shortcomings of others without resulting to personal attacks. Glad to hear from you again!

Specializes in OB.
So you admit to deliberately mis-gendering me to get a rise? Well now i need legislation to make sure I, as a minority in the nursing field, never have to be subjected to people like you and your kind!

Wait, no I don't. I'm a rational adult and can understand the shortcomings of others without resulting to personal attacks. Glad to hear from you again!

Would you consider a black patient irrational for not wanting to be referred to by the staff at their LTAC facility as the N word? A female patient by the C word?

That is what it would be like for a transgender patient to be deliberately ignored in their requests to be called the pronoun they identify with, or to be transferred without warning because staff finds them disgusting. That is the point of anti-discrimination laws---to protect the vulnerable. No one is out to entrap you in your "shortcomings." No one would take your license away if you mess up on the pronoun a few times. It's talking about deliberate cruelty, and yes, it's out there. Nurses are human beings and as such, cruel nurses do exist. Wrap your head around it and move on.

Specializes in Hospice.

[quote=DaveICURN;9608423)

So you admit to deliberately mis-gendering me to get a rise? Well now i need legislation to make sure I, as a minority in the nursing field, never have to be subjected to people like you and your kind!

Wait, no I don't. I'm a rational adult and can understand the shortcomings of others without resulting to personal attacks. Glad to hear from you again!

Made you squirm, though, didn't it?

So you admit that such behavior is abuse but that you, as a so-called "rational adult", have the right to do it anyway without being held responsible for your behavior? Remember, we are talking about adults living in ltc, and you, as an employee in their home, deliberately subjecting them to verbal abuse.

Specializes in Geriatrics, Dialysis.

This is a topic near and dear to me. Anybody who knows me in my personal life would easily figure out who I am when I tell you that my daughter in law used to be my son in law. Now that she is living as who she is and not as who she was born as she is a happier, healthier person. I have to admit as much as I love her I slipped and called her "him" or by her birth name a few times, especially in the beginning when the transition was new. I chalk that up to years of knowing her by her birth name, once I got thoroughly used to using her chosen name I never made that mistake again.

Keeping in mind this law only seems to affect LTC facilities there really shouldn't be the confusion staff could encounter in an acute care setting. I get the point of making sure you are giving the correct meds to the correct patient, and I get that could be a challenge in an ER if the patient says their name is Jane and they look like a Jane but all their legal documentation says they are John. One of the big issues my daughter in law faced was getting everything changed to her preferred name and in such a connected world this wasn't as easy as you would think. The driver's license and social security number were the easiest things to change. She had to go to court for the legal name change and changing her birth certificate from male to female and then provide a copy of the documentation proving who she now was to everybody from her cable provider to her medical provider. Oddly enough a big downfall has been with the name change her chosen, legal name and sex no longer matched her SSN for the purposes of credit reporting and her credit score pretty much disappeared. She's still fighting to restore that.

It's especially difficult for the transgender person to navigate this legal minefield before the name and gender change become part of the legal record. But we have people now in LTC who for whatever reason don't go by their legal name and there are ways to get around this in our documentation. My point is that the legal transition can be a long, drawn out and time consuming affair. It's a step that not every transgender has the resources to take and until or if they do make the change legal it's still important to honor their wishes to referred to by their chosen name and sex. When that legal step of changing your entire life is finally done I can see why after taking so long to have the right to legally be who you are a transgender person would be highly insulted when ignorant people insist on referring to them as who they were.

Specializes in Hospice.

If we were talking about just a pronoun used mistakenly or because a worker is new to working with trans folk, I would probably agree that this law is a bridge too far. It's the people unwilling to accept the reality of transgender, who are most likely to become abusive in their insistence on forcing the transgender person to conform to the the worker's idea of appropriate gender presentation and behavior. This is the abuse the law is intended to address.

The OP's inability to recognize this and his attempt to play the victim tell me all I need to know about his attitudes.

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