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.

Would it be wrong of me as a health care provider to encourage a Pt who may be experiencing Gender Dysphoria to speak with a counciler before serious life decision? At what point am I no longer allowed to express my logical reason for fear of hurting feelings?

The law in question affects residents in SNF/LTC facilities who are mostly senior citizens. I would think that anyone aged 65 or older has made their "serious life decisions" long before coming to LTC :)

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.

Why would you assume that? Why assume about something so important? Something obvious to some is not always obvious to all.

I think several jumped on OP. I didn't go back to count, so am not sure. No matter.

His stunning lack of cultural sensitivity could be based in ignorance, not real insensitivity.

We should never assume.

The law in question affects residents in SNF/LTC facilities who are mostly senior citizens. I would think that anyone aged 65 or older has made their "serious life decisions" long before coming to LTC :)

That is not necessarily so. A 65 year old could live another 30+ years.

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.

So the possibility that he just really didn't know the issues is just nonexistent, is it? God, it's hard to comprehend such suspiciousness on your part, if that's a word, but you get my point.

non-recognition, play the victim, assuming

Lord Jesus, come back quickly.

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.

insulted by ignorance? Just educate people. Respectfully, just as you wish to be treated. Flies, honey, vinegar, all that.

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.

How about the vulnerable roommates of these folks? Do they have any rights? like to be housed with a bio female if she is female or bio male if he is male?

That is not necessarily so. A 65 year old could live another 30+ years.

If you look at the context of the quote, DaveRN was questioning whether he should help folks with gender dysphoria realize that they really are just confused about their gender. My point was that the vast majority of seniors have a pretty good idea what gender they are :)

How about the vulnerable roommates of these folks? Do they have any rights? like to be housed with a bio female if she is female or bio male if he is male?

The last LTC/SNF I was employed by had a transgender resident. She was given a private room. The policy (invented on the fly I think because it was a first for the facility) was she would be in a private room unless we had another resident admit who was also a transgender female.

Specializes in OB.
How about the vulnerable roommates of these folks? Do they have any rights? like to be housed with a bio female if she is female or bio male if he is male?

What about them? That's a totally separate issue that this law (unless I missed a part) does not address, and it's this law we're talking about. As the previous poster said, arrangements could certainly be made for uncomfortable roommates, it's not as if every other resident in LTC is transgender and the whole system as it stands would implode.

How about the vulnerable roommates of these folks? Do they have any rights? like to be housed with a bio female if she is female or bio male if he is male?

So let's say you can't even tell someone is trans because they look "bio", so then what do a chromosone test? Is the line drawn by how someone looks or by how they identify?

What about refusing to share a room with someone of a particular sexual orientation?

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