So we recently admitted a male patient who identifies himself as female. We don't get many patients like her. A nurse in particular let's his political views get in the way of work and has been calling this patient "it".
Now, let's fast forward to the dilemma. During medication pass, he addressed the patient as "it" out loud and other staff and patients started laughing; next thing you know, we had a behavioral emergency on our hands.
I filled out an incident report because several other nurses and I have spoken to this nurse prior to the event happening. One nurse even brought it up the chain of command. Not only is it unprofessional but it's endangering the safety of others - clearly, it's one of her triggers. Has anyone ever dealt with this type of conduct?
@RedKryptonite: you're spot on with your summary of some of the psychiatric risks faced by TG people.
I like your approach, too: first do no harm. The question at hand is not whether the TG identity itself is pathological. It's how do we meet TG patients' needs in the moment. It's neither PC nor PI to be competent professionals. It's what they're paying us for.
Em nope. "hello betty, the fact that you were born a male and feel you are really a female means that you are mentally disturbed" IMO is as offensive as calling them an 'it"
The recent TG lady that i met was a fairly well adjusted human being.
In NZ, anyone wanting to go through surgery is required to undergo a multitude of testing and living as their gender of choice for a minimum of 2 years. If its considered the person is mentally unwell they wont be accepted for surgery
I think your last comment proves the original point Red Kryptonite made.... that extensive psychiatric testing needs to be done first.
And I see your extremely large sample size of TG individuals you have met. Please tell us more about how "fairly well adjusted" all TG individuals are.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Is there a way to block users on here?
Yes. I've used this "ignore" feature a few times when what someone was saying evoked a response that could upset me for hours. The admins here seemed to feel it should be temporary and in one case I un-ignored someone and learned to understand where they were coming from, if not agree with them.
1. Click on your username or "my account"
2. Click on the account tab under your name and avatar.
3. Click on the green "see all account options" bar.
4. See "Ignore List" option where you can add or remove users from your list.
I may have misunderstood your point but elective surgery is most certainly a choice. No one is kidnapping you and forcing you to have your bits and pieces revised. Cancer is not a choice. Big difference.
Perhaps there is a misunderstanding between affliction and treatment.
Gender Identity Dysphoria is an affliction. Cancer is a disease.
You don't choose to have it, you choose to treat it.
I have always been extremely supportive of the LGBT community. I have several homosexual people in my life and have had less than a handful of transgender people who I was very close with. They walk among you, and you will never be able to tell with some.
As far as in a clinical setting...if you have an Elizabeth that prefers to be called Betty, do you not call her Betty? Last time I checked, we provide holistic care. Care for the WHOLE PERSON. Whether transgender is a psych issue or if someone really is born in the wrong body we will physiologically and psychologically never know and it is not our place as nurses providing care to debate. If we have a completely oriented person who is physically a male but identifies as a female, it is not our decision to debate what they think. We are providing care, and part of that care is to respect each individual's beliefs. We refer to them as what they believe they are.
Now, it's completely different when you've got someone who is a psych patient deciding they have a new identity every day. Then you go with whatever treatment plan they have.
But as far as report, I think it's important to know because you don't want to embarrass the patient. If I walked in to Ed's room and started a head to toe and discovered Ed had a lady parts, it might take a minute to mask my surprise, and I would feel bad if it made the patient feel some sort of way. I try to be very nonjudgmental but a surprise is a surprise. Care providers should be aware.
It's cold hearted, but so is calling a patient 'fat' or any other slur. Says more about the nurse than it does about the patient. I'm really interested to find out if environmental toxins(BPA estrogen mimickers in plastics, etc... play a role in gender dysphoria.
A friend I've known for 20+ years came out a couple years ago as a trans man and is in transition, considering surgery. He's been a great go-to for questions on how to handle certain issues WRT the trans community as I (slowly) make my way through NP school. When we were in high school together, he (in those days still identified as 'she') was the first person - and an upperclassman at that - to befriend me as the 'new kid' on my first day of my freshman year.
When he first came out to me he told me that as soon as puberty hit he used to go to bed every night praying he'd wake up a boy the next day. We went to a very small private high school that was not exactly a bastion of tolerance for this sort of thing. I can't imagine the hell he went through not being able to tell anyone. To date he has still not come out to his parents, although he's sure they probably sort of know.
He would be absolutely destroyed if anyone called him an 'it'.
Ask people their preferred pronouns and use them. I do know a small number of people who actually prefer it, as they feel he and she do not represent them, but they are the exception of the rule. Calling a Trans woman it when they have made it clear they are a she is invalidating. It's like telling an asexual person they just haven't met the right person yet. We do not get to decide what other people feel.
Of course it's a psychiatric issue. Could we stop being so PC that words literally lose all meaning?
Feeling that the body you have is not the one you should have is a psychiatric issue.
@RedKryptonite: you're spot on with your summary of some of the psychiatric risks faced by TG people.
I like your approach, too: first do no harm. The question at hand is not whether the TG identity itself is pathological. It's how do we meet TG patients' needs in the moment. It's neither PC nor PI to be competent professionals. It's what they're paying us for.
I want to point out that saying TG people face psychiatric risks, and saying that TG is a psychiatric condition in and of itself are two wildly different things.
Of course TG individuals face psychiatric risks and tend to not be "well adjusted". TG people have to choose between suppressing themselves every minute of every day, or being true to themselves and facing violence and rejection every minute of every day. Kind of hard to be well adjusted under those circumstances. Where is their maladjustment really stemming from? I'd say from the experience of being TG in a society that does not accept them..... not from transgender identity being inherently "unbalanced" or anything.
It wasn't that long ago that homosexuality was considered a mental disorder. And not too long before that women were diagnosed with a whole range of bogus "hysteria" disorders. The common thread between these scenarios, and labeling TG as a psychological disorder, is a desire to separate ourselves from those who make us uncomfortable. Makes discriminating against them so much more palatable.
I read in some earlier post that a TG person would be "devastated" if called it and that this is why TG people kill themselves. I believe that it is extremely telling if your joy and even your sanity hinges on an insult from some crackpot. If you know who you are and are happy with your choices, why the need for constant validation and co-signing from every person you come in contact with ? And yes nurses have an ethical obligation to not be jerks to their patients but it is a general attitude I see even with laypeople. You are a bully or bigot if you don't agree with and campaign for the cause/minority/victim d'jour.
I know quite a bit about the transgender community. The emotional hardships they endure "coming out" and transitioning, and the sometimes-years of mental anguish they go through before then just to get to that point, are significant and valid. Calling them "it," "heshe," "shim," or any other disrespectful name contributes to the destruction of their hard-fought-for identities and debases their very humanity. People aren't people because of what's between their legs and in their hearts? Please. We are nurses and we are beyond that.
That being said, I did have a transgender patient during my very first clinical as a nursing student, and a professor who referred to him by some of those very names. I didn't speak up. I wish I had spoken up. Please speak up, for your patients. I was too green and too dumb to realize this was about more than myself and possible ramifications for me; by not speaking up I silently contributed to that patient's debasement and I will forever regret that.
heron, ASN, RN
4,633 Posts
@RedKryptonite: you're spot on with your summary of some of the psychiatric risks faced by TG people.
I like your approach, too: first do no harm. The question at hand is not whether the TG identity itself is pathological. It's how do we meet TG patients' needs in the moment. It's neither PC nor PI to be competent professionals. It's what they're paying us for.