Patients with gender identity issues

[Umberlee]

We have a pretty significant proportion of patients with gender-identity issues admitted here. There is no continuity to how we address these patients--some staff refer to them per their gender of birth and their birth name, and others respect the gender they identify with and refer to them as their name of choice and gender of identity. It's disconcerting to see the lack of continuity and I'm thinking of bringing it up at our next nursing meeting. I feel like we should refer to the patient per the gender they identify with, especially in light that the dissonance over their gender identity is typically such a huge component of their suicidality.

Patients are also typically roomed with same-sex roommates regardless of their gender identity. This seems like a bit thornier of a problem as far as liabilities and patient safety and such though.

How does your workplace address gender identity issues? Is anyone aware of any sources or data regarding treatment of patients with gender identity issues and evidence on improved outcomes? I have not found much but would love to be able to present something to the nursing team to improve the likelihood that staff would adhere to respecting patients' gender identities.

[lindseylpn]

I've only had a few patients that identify themselves with the opposite gender but, I refer to them with whatever gender they prefer. If I wasn't sure what they would like to be called I just tried not to say sir, mam etc. I once had a patient that was indecisive and went back and forth but, I always used whatever name they preferred. This was in a clinic office and reception and management always used their given name.

[Mandychelle79, ASN, RN]

We do not get many but when we do the patient gets a private room and we use whichever name we are asked to use.

[Meriwhen, ASN, BSN, MSN, RN]

My facility will call transgendered patients or patients with gender issues by whatever name they wish to be called; however all records are maintained in the patient's legal name.

As far as gender goes, if the patient identifies as male, we'll refer to them as "he"; if they identify as a female, it's "she." We house them in a single room if we can. Not sure what gender goes down on the records...I think it's what they biologically are, so if they're a pre-surgery MTF, we'll call her a "she" but the records will say "male."

[MrChicagoRN, RN]

Their legal name is what's in the record. They should be called by whatever name they prefer.

In report, it can be something like "William Smith, 28 y/o transgendered male to female, prefers to be called Sarah"

[Umberlee]

Wow, it seems like across the board your workplaces are pretty progressive. There is no "canonized" way to address pts with gender identity issues at the hospital where I work so it's usually a split of half the staff referring to the pt by their birth name and half by their name/gender of identity.

[pixiestudent2]

Wow, it seems like across the board your workplaces are pretty progressive. There is no "canonized" way to address pts with gender identity issues at the hospital where I work so it's usually a split of half the staff referring to the pt by their birth name and half by their name/gender of identity.

Hmm, it just seems highly disrespectful to go against the patient's wishes to call them by their chosen name... Especially those that are suicidal

[SHGR, MSN, RN, CNS]

I worked briefly at a clinic that has a transgender program. They change the record to be the patient's chosen name and their gender identity. It's a very progressive place.

[Meriwhen, ASN, BSN, MSN, RN]

Hmm, it just seems highly disrespectful to go against the patient's wishes to call them by their chosen name... Especially those that are suicidal

Agreed.

Actually, we'll call any patient by their requested name as long as the name isn't offensive. Nicknames can make things confusing though, but some patients really will not respond otherwise.

[elkpark]

We do not get many but when we do the patient gets a private room and we use whichever name we are asked to use.

Ditto.

[TerpGal02, ASN]

We always call the pt whatever name they wish to be called. Our facilities deal with all ages, and I have seen transgendered pts as young as 11. Some of our staff are not really respectful when it comes to pronouns with the adolescents and it seems to always be the FTM adolescents. It's not usually a problem with the MTFs, although the only MTF I have seen was the child. Adults are pretty well respected as far as the pronouns go. The child has been with us twice, the first time we had to use her legal male name on everything but called her her chosen name. The second time the parents had legally changed the child's name. That kiddo, I swear if you didn't know she was born male you would NEVER second guess she was a girl. There was nothing boy about her. Very delicate features, female mannerisms, etc. She kept coming in because of issues at school. Not with the other kids but with the ADULTS at school. Sad.