Nursing's Transition: Creating Inclusive Healthcare Settings for Transgendered Patients
Transgender patients should be able to access healthcare without fear or ridicule. By advocating for the individual needs of our patients we can continue to strive for quality outcomes for everyone.
The waiting room is busy; she sits gently pulling at the edge of her new Summer dress. It seemed like such a smart buy earlier in the week but now leafing through the shiny guide she received at the new employee orientation she wonders if the bright blue flower pattern and sleeveless cut is a bit too flashy for the office. Next to her is the stack of paperwork which she has dutifully completed, such a joyful task. The clock ticks on, she chews nervously on her pencil. She thinks back to other appointments, ones similar to this, she breathes in and lets out a long sigh. Finally the door opens, the nurse steps out and calls loudly, "David, the doctor will see you now". She stands, a swirl of Azure wilted by a moment of ignorance.
The story of "David", although fictional, is based upon the realistic events of a Transwoman, assigned a male gender at birth, now identifying as a female. Transgender individuals often avoid seeking healthcare related to fear and the potential for discrimination. Nurses are often the first contact that patients make when receiving care so they play a crucial role in developing rapport with their patients and creating welcoming environments.
Transgender is the general term used when referring to people who identify with a different gender than what they were assigned at birth. It really is not possible to get an accurate count on the number of people in the world that are transgender since the statistics are sketchy due to under reporting. With the accomplishments of actress/producer/LGBTQ advocateLaverne Cox as well as the recent outing of Olympic athlete, formerly known as Bruce Jenner, transgender topics have become more acceptable in social media. However the potential for violence and discrimination are still major issues for most patients. It is for this reason that it is not uncommon for patients to limit interactions with providers based upon feelings of anxiety or negative past experiences.
Issues with insurance coverage for medically necessary gender-related care or inappropriate care, reprisal at work related to their gender identity/need for medical procedures, and general access to medical services needed within their communities are frequent worries for patients. Lack of continuity of care and noncompliance with treatment is cause for concern as it relates to such medical disorders such as diabetes, heart disease, substance abuse, HIV, and mental health conditions. In recent studies, transgender patients were found 9 times more likely to have attempted suicide than the average person. Social risks such homelessness and lack of support systems were known to be high stressors. Refusal of care by medical providers and discrimination were also key factors for suicide risk.
Transgender patients should be able to access healthcare without fear or ridicule. Barriers to care exist in all environments and need to be broken efficiently. It is extremely important to educate yourself and others within your workplace in an effort to create safe, inclusive, patient centered care facilities. Increased awareness of barriers that patients may have already encountered prior to our visit allows us to appreciate the potential for underlying apprehension and frustration they may be experiencing. Nursing staff may also have feelings of nervousness stemming from a lack of knowledge regarding Transgender patients. Our own approach and demeanor can allow us to better anticipate the needs of the patient to improve overall outcomes.
What can nurses do to reduce stigma and make their workplaces more sensitive to the LGBTQ/transgender community? Focus on making sure that you are properly educated and share your knowledge with your colleagues. Be sure to use transgender affirmative and inclusive language. Ask patients their preference for word choice, especially when using names, pronouns, and other words to describe their body. It is important to ensure that environments are welcoming to the LGBTQ/transgender community. This can be accomplished through the display of LGBTQ acceptance signage as well as educational materials in the waiting room. Lastly, never assume! Whether it is the gender of a person, sexual orientation, or the answer to another health related question, nurses cannot avoid asking the questions necessary to properly assess and care for patients even if they are embarrassing or difficult. Remembering to incorporate sensitivity from the beginning of our assessment all the way through care delivery is a must! Respecting the individual needs of our patients and advocating for quality care has always been the nurse's forte. Ensuring that we do all that we can for the transgender population to receive the healthcare services that they deserve should be no different.
So how about the people who feel they are "trans-abled"? I bet you haven't heard of that yet, have you? There's a subset of people out there who feel they should have been born without an arm, or a legs or eyes or what have you. They try to attain surgery to correct what they feel is a mistake and get to the "true them". Sound like mental illness to you? It sure does to me.
Feel free to google for this, I'm not making it up.
Are you going to believe that people born with vision are anything less than mentally ill when they WANT to be blinded?
How are you going to reconcile your belief in transsexuals vs that of trans-abled?
Where does it stop? Is wanting to be a horse ok? Should society and individuals just overlook what is decidedly mental illness because it might actually offend someone?
Transexual A. Does not require someone go through surgery. Some do, some don't. Some don't even do hormone treatments. It depends on the individual person and you cannot judge the whole by one extreme that you think they are. B Even if the individual does decide to go the full surgical route does it affect their ability to function in society? No, it doesn't. Most trans people are fully intergrated members of our society.
Unlike the transabled, who have a verifiable mental illness they are not disabling themselves to be how they want. I understand that transabled tend to resolve once they have what they want, but it's comparing apples to oranges.
Unlike the transabled, who have a verifiable mental illness they are not disabling themselves to be how they want. I understand that transabled tend to resolve once they have what they want, but it's comparing apples to oranges.
They just don't have their own lobbying group yet. Give it ten years.
So cutting off an arm is a nihilistic delusion, but cutting off the member is seeking the "true self". Oh this makes me laugh.
This post right here, shows that you are completely ignorant of transgender issues or how the surgery is done. In M2F sugery, the member is not simply cut off.
We have to be careful not to make our glasses too rose-colored, also, though. There is also evidence that gender reassignment doesn't solve a fair number of transgendered people's problems. While for some, massively body-altering surgery ends up being the right path, others end up with regret and still unable to feel comfortable in their bodies. Then what do they do? We shouldn't get to the point where such irreversible steps are too easily accepted, causing more damage than help.
When you live in a society that thinks it is perfectly okay to tell you you're crazy for how you want to live, where people are violent towards you and kill others who are like you for being out about it, it's kind of hard on the person. Do you think that if someone could transition with no outside pressure from society they would still have regerts? Look at some of the tribal cultures where trans individuals are honored and allowed to live as who they are in peace and treated respectfully. They don't have the same issues in those cultures.
Specializes in Oncology; medical specialty website.
I think the best comparison in this entire thread is the Witness nurse. Witnesses don't accept blood, but that doesn't matter in that nurses practice, it only matters in that nurses everyday life. I went to school with a Witness and asked her extensively about her beliefs on transfusion (super interesting to me), she said she didn't believe in it for herself personally, but she'd advocate for it for a patient who needed it. Because it wasn't about her, it was about the patient.
It's not about me or my beliefs, it's about my patients. My thoughts on the Trans issue don't matter. The patient matters. This shouldn't even be a discussion. Address the pt by the preferred identifier and if they ask you about YOUR beliefs remind them it only matters what they believe and that they will find no judgment from you.
Thanks. I thought long and hard about posting that, because those conversations tend to get acrimonious...and that's on a good day. But it seemed to be an apt comparison.
So how about the people who feel they are "trans-abled"? I bet you haven't heard of that yet, have you? There's a subset of people out there who feel they should have been born without an arm, or a legs or eyes or what have you. They try to attain surgery to correct what they feel is a mistake and get to the "true them". Sound like mental illness to you? It sure does to me.
Feel free to google for this, I'm not making it up.
Are you going to believe that people born with vision are anything less than mentally ill when they WANT to be blinded?
How are you going to reconcile your belief in transsexuals vs that of trans-abled?
Where does it stop? Is wanting to be a horse ok? Should society and individuals just overlook what is decidedly mental illness because it might actually offend someone?
Bottom line, we all have thoughts, opinions, beliefs, and questions inside our heads about this and many other topics, and that's where they should stay when providing patient care. Professional boundaries are an awesome thing, and critical to develop. The human in front of you needs care. Your job is to provide care respectfully and compassionately. So get on about doing that, and if you can't keep the thoughts in your head from affecting your care, then find something else to do.
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
Once again I will point out.....keep your comments on topic. This is not the place to discuss/debate dogma, theology, religious beliefs, sin, or even why a person (patient) is the way they are. It is certainly not the place to label or personally attack people or use divisive, condescending, and derogatory comments.
Please respectfully discuss how we as nurses can provide professional and unbiased nursing care to transgendered patients.......which happens to be the topic of this discussion thread.
Posts will be deleted and points assigned if this continues.
And I cannot think of anything much worse than even making a remote contribution to someone else's pain or, the unimaginable, suicide. Now that's a choice we make. We can shine light or darkness on another. I don't ever want to think I brought darkness to someone vulnerable to me.
This. Every human being deserves to receive compassionate, unbiased, competent nursing care. We care for people at their most vulnerable, words and attitudes can do a lot of damage. Anyone who cannot or will not leave their religious beliefs/prejudices/personal opinions at home has NO business being a nurse. Period.
Anyone who cannot or will not leave their religious beliefs/prejudices/personal opinions at home has NO business being a nurse. Period.
Glad you're here to dictate to the rest of humanity how we should feel about x anything from your self righteous perch. You far left lunatics have infected every corner of life and think that you're right about whatever the topic at hand might be at the time just because you say so. I did not give up my individuality when I became a nurse and I damn well didn't ask for your approval about any opinion I hold. So you can step off with your pronouncements about what I should think at any given point in life about any topic.
The very idea that I'm supposed to be your drone and mirror your attitudes and wishes is patently offensive.
Glad you're here to dictate to the rest of humanity how we should feel about x anything from your self righteous perch.
That's not what was said at all. Feel any way you like, think whatever you like, believe whatever you like, but keep it away from the patient. Give respectful, compassionate care such as you'd want for yourself to all patients, or else change jobs. You know, do unto others as you'd have done to you......sound familiar?
tutelary
15 Posts
So cutting off an arm is a nihilistic delusion, but cutting off the member is seeking the "true self". Oh this makes me laugh.