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.
I am sorry, if you read your Bible, men were created to be men, and women were created to be women. When the LORD mentions transgender and gay people, it is for judgment on their sin. Genesis 19, Romans 1, and Revelation 21:8 are warning passages from the LORD for those who do such things. Are you saying God made sin? Please show me in the Bible where it specifically states that God made transgender and gay people who they have chosen to be.
Specializes in OR, Nursing Professional Development.
transgender and gay people who they have chosen to be.
Parakeet, please realize that in the vast majority of cases (and I mean there are likely to be very few outliers), people who are gay or transgender did not choose to be that way. I certainly didn't, and fighting who I am (not who I choose to be) did more damage than good. No one would choose to live through the discrimination, threats, violence, and everything else that we could potentially face on a daily basis.
Think of it this way: if sexuality is a choice, when did you choose to be heterosexual? I'm going to bet that you'll say you never chose it; it's how you are. Well, for those of us who are LGBTQ, we didn't choose it either; it's how we are.
I am sorry, I really should not rant unless asked to. I just had to respond to Farawyn. Would you all like for me to continue, or leave this thread. I don't want to lose my cool......or cause others to do such.
I am sorry, I really should not rant unless asked to. I just had to respond to Farawyn. Would you all like for me to continue, or leave this thread. I don't want to lose my cool......or cause others to do such.
Meh, I'm fine. Thanks for your concern, though. Don't leave on account of me!
And in response to you, I think Rose_Queen said it very well. It is not a choice.
Specializes in Oncology; medical specialty website.
The Bible clearly defines men as men and women as women. It says that cross gender is an abomination to the LORD.
Where does the Bible state that cross-gender identification is an abomination to the Lord?
You have much to learn. You do not have to agree with what a patient does, what choices a patient makes to provide care for the patient. As a Jehovah's Witness, I believe it's wrong to accept a blood transfusion. I believe the Bible clearly states this prohibition. However, as a nurse, I can't impose my beliefs on a patient who may feel differently about getting blood. So I provide whatever care that patient needs. (Note: I am not going to start a debate about blood transfusions.)
When you go into nursing, it's not about you, it's about the patient and what s/he needs. If you can't set aside your personal biases, then perhaps this profession is not for you.
I am sorry, if you read your Bible, men were created to be men, and women were created to be women. When the LORD mentions transgender and gay people, it is for judgment on their sin. Genesis 19, Romans 1, and Revelation 21:8 are warning passages from the LORD for those who do such things. Are you saying God made sin? Please show me in the Bible where it specifically states that God made transgender and gay people who they have chosen to be.
I will defend your position so far. I'm starting to think you're looking for converts and not advice.
It doesn't matter to me one bit, who or what a person is or was, once I assume responsibility for their care. Sometimes I don't want to know, because it might influence that care. We frequently get prisoners, and if any patient could test my compassion it would be them.
Wow. How utterly offensive! Keep your religion out of our profession as you may offend your patients and fellow nurses. It's not about you. As an openly GAY nurse who did not choose to be and does not believe in your god or any other, I don't think you should be allowed to work as a nurse with that kind of viewpoint. You're biased and prejudiced and I'm disgusted reading this nonsense. I don't care what you believe in private but forcing your offensive ideology on your patients is just immoral. Please find another profession.
I only responded as such because Farawyn made a strong statement that God made people cross gender and gay. I have already stated that I am not going to push my beliefs on patients or others unless they ask or debate with me. To note: I responded with Bible to another nurse, not a patient. That should not be taken as I if I am going to immediately challenge a transgender person because they do not believe what I believe. I do understand what some of you have stated, I can just call them by their first names always. To that, I do not have as much of a problem. I have had friends whose names could go either way. I have just called them by the name they wanted to be called. My issue in this thread was about a situation in which a person who is clearly a man, is referred to as a woman.... and vice versa.
Some of you may think now that I will make a terrible nurse. Time will tell. So far, I have to become one first. My instructors and classmates have see where I stand, and even though they may not agree with me, they have strongly encouraged me about nursing. I am looking into overseas medical missions, just so you know, you don't have to be worried about working with me eventually! :)
I have just called them by the name they wanted to be called. My issue in this thread was about a situation in which a person who is clearly a man, is referred to as a woman.... and vice versa.
And therein lies the problem. Your opinion of what constitutes a male or female in this regard is irrelevant. Because it's not about you! In any event, your beliefs are clearly offensive to others, including myself, and you might want to take a basic nursing equality and diversity class before you go any further in your career. Modern nursing has no place for extreme religious views. If I was a patient I would be horrified to have you as my nurse if I thought for a second you might prevent my partner from being treated equally at the bedside as my family member and included in my care as would be my wishes.
Do Parakeet and NeoNatMom understand that there are REAMS of properly conducted research studies which indicate that sexual orientation is biologically determined? In which case, who sexually excites any given person is not a conscious choice, but part of who we are-no matter if we try to convince ourselves otherwise?
NeoNatMom
1 Article; 676 Posts
Im a Christian, but find you hilarious and you make valid points.