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 definitely won't flame to what you have said. This is actually part of what I was meaning by the many things I don't agree with. I don't believe being gay, lesbian, transgender or anything outside of God's design is right. There is no going around it as a Christian, though many people would like argue that perhaps God didn't mean it how we make it out to be understood. But that is just trying to adjust the Bible to fit their own desires so the world will be more acceptable toward them. And that does bring me to your latest point; Jesus was never about trying to dilute His teaching so it would make others like Him more, because then He would be lying and according to what we have learned He never sinned so clearly He was honest, but gentle with the hurt that needed healing.
I guess in more clear terms, I would be honest if I had a patient ask me how I perceived things. I don't care to be politically correct to make others comfortable while I keep my mouth shut and remain unimportant about my feelings on the matter. However, if someone wants me to address them by a name typically meant for the opposite gender, I would do it. Why? Because they can be named anything, regardless of their gender. Refusal to care for a transgender or gay patient is not only unethical, its sinful, but this statement is just be reiterating another person's post prior to ours. I still am very weary on if I would address someone by a pronoun not biologically fit to them, but I feel I need to do more Bible studying to solidify more what I believe regarding how Jesus would hand has handled situations similar to these. Right now, I would probably have to remain silent on pronouns and stick to saying their full name. then again, I am a new nursing student, so I am lacking in experience ans insight, both as a future nurse, and a Christian. I have more growth to do all around.
Did you know that it is absolutely possible to be Christian as well as gay, bi, Trans and many other things that conservative Christian do not alway find biblical? I believe heavenly father gave each of us our own tests and challenges. I also believe that he wants us to love and respect our brothers and sisters even if we do not agree with their life. It's not our place to judge. Then again, I have tattoos and piercings, so according to some, since I damaged the body I was gifted with purposefully, I'm going to the that super hot place of fire and brimstone.
I beg to differ, but it is not possible. Someone who defiantly breaks the laws that the LORD God set in place is not a Christian. A Christian is a person who has surrendered their entire life and will to the Lordship of Jesus Christ. Such a person would live as Christ wanted them to and not for their own desires.
And no, we have people in our church who have tattooed themselves before they came to Christ. They did so in ignorance, and now regret it. I do not consider them any less Christian than anyone else. Now someone who has knowledge of God's will and Word and does not obey it...they are in the wrong.
Actually, I am not indignant. I just want to know if I will ever have a chance at nursing here in the U.S. Yes, there are Biblically right and wrong laws. Aside from that, I was trying to point out that transgenderism being legalized and accepted by our culture is relatively new.
Could always work at a Catholic hospital where biblical principles guide the care if you're that concerned about being forced to compromise your beliefs. It may make running into gay or Trans patients less likely, but you probably still will.
I beg to differ, but it is not possible. Someone who defiantly breaks the laws that the LORD God set in place is not a Christian. A Christian is a person who has surrendered their entire life and will to the Lordship of Jesus Christ. Such a person would live as Christ wanted them to and not for their own desires.
And no, we have people in our church who have tattooed themselves before they came to Christ. They did so in ignorance, and now regret it. I do not consider them any less Christian than anyone else. Now someone who has knowledge of God's will and Word and does not obey it...they are in the wrong.
Isn't it part of Christian belief that we inherently flawed, we are all sinners, none of us are perfect but through the blood of the savior we are saved? A Christian is someone that believes in that Jesus Christ is the son of God sent to save us all. That is all that is needed to make someone Christian, the only common belief between all Christian denominations.
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
ADMIN REQUEST
Many posts are straying off the topic of the thread which is to discuss how nurses can help to provide competent, inclusive, welcoming, and professional nursing care for transgendered patients.
While talking about differences in religious beliefs is a great topic to discuss, it is not the topic of this thread. This would make a great topic of discussion in another thread. It is good to know what your beliefs are....... they are an important part of who you are. You are not expected to totally abandon your beliefs at the workplace. However, as a healthcare professional, you are expected to not let your beliefs affect your ability to provide unbiased care for all patients, always remembering that it is not about you but the patient. Discussion on how to do this is quite appropriate in this discussion, especially if this is something that is challenging for you.
Please refrain from judgmental, personally attacking, or derogatory comments. It is important to be respectful to those that have opinions that differ from yours.
I don't see the relevance in whether gender identity is a choice or not. This is a country of individual freedoms as long as no law is broken.
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.
One other quick side note, off topic of the thread, but since it was brought up: the Bible and slavery. There are passages that acknowledge the reality of slavery/war captivity/indentured servitude of the time, and sets certain rules of engagement.
However, regarding the practice of enslaving one ethnic group under another, as was the practice in the US, UK, etc.? There is not so much as a verse that supports that. I've heard many times that religion was a justification for slavery in the US, but nobody has ever been able to show me the passages--professing Christians making that assertion included. They're not in there.
Carry on.
My parallel with bringing up slavery was related to Parakeet asserting that it was illegal to be gay in the past. Slavery was legal in the past.
jaycam, RN
1 Article; 459 Posts
Did you know that it is absolutely possible to be Christian as well as gay, bi, Trans and many other things that conservative Christian do not alway find biblical? I believe heavenly father gave each of us our own tests and challenges. I also believe that he wants us to love and respect our brothers and sisters even if we do not agree with their life. It's not our place to judge. Then again, I have tattoos and piercings, so according to some, since I damaged the body I was gifted with purposefully, I'm going to the that super hot place of fire and brimstone.