Confusion involving Transgender cultural needs.

[jaycam, RN]

I recently came into a situation not involving school or nursing that I would love to have clarification on. I know we do have some nurses here who are transgender or work with transgender clients so I felt here would be a safe place to ask for clarification.

I should start by saying I am Cisgendered, but have PCOS with some of the lovely side effects like facial hair. I was with a group of acquaintances that included several trans individuals who were talking about how developing features related to a gender they didn't identify with was unpleasant for them, something I can certainly relate to as I can grow side burns that put some men's to shame and it's very obvious and hard to hide. They were pretty open to my relating to them, but I ran into trouble with it when it came to biological sex vs gender.

As I have been lead to believe, biological sex and gender are not the same thing. My biological sex is that I have female reproductive organs and my actual care plan will include that if needed. My gender happens to be female as well, but that is not reliant on my physiological make up.

How can I discuss things that involve having ovaries vs testes, without having people make the connection that I am saying that "females have ovaries" or "males have testes" without issues?

[Alex Egan, LPN, EMT-B]

Oh boy. Ok here comes my prospective.

The he psycosocial issues with being grabs are numerous and very personal, based in that persons gender identity. Psychosocial goals would have to be adapted as necessary. I imagine firstly establishing pronouns and such. However where the rubber meets the road as far as health education the persons sex and sexual activity really dictates the education they will need. A trans man (male gender/female sex), may or may not be sexually active with men. May require education on birth control, and STD prevention in the same manner as a cis woman. Similarly a trans woman (female gender/ male sex) may need education similar to a gay male if they prefer male on male sex regardless of one partner identifies as female. You just have to adjust the education according to preference and activity. Simply ask pertinent questions in a non judgmental profession manor to determine what is needed.

This is really just my best stab at this based on my understanding of the trans comunity, which I'm sure is incomplete.

[jadelpn, LPN, EMT-B]

There are parents who currently use a non-gender parenting technique. My kid, who is a teacher, has to have a non-gender classroom, with non-gender communication.

With all that being said, because someone has organs of a certain nature (ie:a uterus, ovaries, testes etc) does not mean that don't and can't identify with being a certain gender. What would come into play is the risk of self mutilation due to the sense that body parts equal gender, and that is just not the case.

I am not sure what the exact answer is, other than say for instance someone only has one kidney. Does that make them any less functioning? One can function and identify with one gender or the other regardless of organs.

I can remember a time (and not even on the level of identity) that I liked mixing it up to the point that you couldn't tell if I were male, female, a drag queen or what. (It was the 80's after all...) It was an artistic expression for me. It made me feel funky and different, and I enjoyed how that made me feel. I can remember being called gay. I was an outcast for a bit in my very small town where alligators and figures on horses reined supreme. And I can remember feeling sad about that.

Bottom line is that whomever one identifies with as far as gender, you need to create a plan of care that meets the person where they are. A lady parts and/or member doesn't make someone feel any less or more like a certain gender if the focus is on identity and not body parts.

We have kids dying at their own hands due to society ideals of normal. We really do as nurses need to pave the way for understanding and function.

And Big Al is absolutely right on with sexual protection regardless of how one practices. And a list of practitioners and multi-disciplines (and support groups f indicated) that are learned in gender identity.