Transgender patient and a dilemma

Nurses General Nursing

Published

So my coworkers and I encountered a bit of a dilemma with a transgender pt. 16 y.o. born female transitioning to male. The pt preferred to be called he so I will refer to them as he. He was a 16 year old who definitely appeared as a female outside of a small amount of chin hair, male haircut and clothes. He was a psychiatric pt who needed a shower. We always send our pts to shower with a chaperone since we are not a psychiatric unit, we are an ER who holds overflows from time to time, and we don't have a shower on unit obviously. With females we send a female security staff member, with males we send a male staff member. We encountered a dilemma here. Obviously the pt was a minor first off. Then we all just looked at each other in confusion as to what gender to send as a chaperone. Do we send the male or the female security?? I mean for the pt's safety and the security staff safety, this was a tough call. The pt could have brought accusations against the staff untruthfully AND who knows anymore the security could have assaulted him! It's like what do you do?? What do yall think? Have yall encountered similar situations? I just feel like we in healthcare are going to be encountering things like this more and more and it could get a bit sticky.

You need to educate yourself on transgender issues. With your attitude, you have no business being anywhere near a transgender patient.

I get it I'm not in your echo chamber. I do nothing but read, study, and converse with victims of gender dysphoria.

The suicide risk post op is incredibly high, the DSM V says for treatment it recommends hormone blockers and surgery if counseling does not work, children can be diagnosed with gender dysphoria which is ridiculous! The DSM V says gender is a spectrum which is just false, Gender Dysphoria and the treatment for it condones self harm, children are being put on puberty blockers which will cause long term effects.

Don't tell me to educate myself!

If anything I'm highly disappointed for healthcare professionals for not being vocal about this or looking into better treatment options for it other than making a victim of gender dysphoria effectively a eunuch.

I feel pity for people that have gender dysphoria and I understand it is an issue.

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I get it I'm not in your echo chamber. I do nothing but read, study, and converse with victims of gender dysphoria.

The suicide risk post op is incredibly high, the DSM V says for treatment it recommends hormone blockers and surgery if counseling does not work, children can be diagnosed with gender dysphoria which is ridiculous! The DSM V says gender is a spectrum which is just false, Gender Dysphoria and the treatment for it condones self harm, children are being put on puberty blockers which will cause long term effects.

Don't tell me to educate myself!

If anything I'm highly disappointed for healthcare professionals for not being vocal about this or looking into better treatment options for it other than making a victim of gender dysphoria effectively a eunuch.

I feel pity for people that have gender dysphoria and I understand it is an issue.

You do not treat gender dysphoria as a health care professional by refusing to acknowledge their gender identity. You CLEARLY have zero understanding of how gender identity is established in humans; it is not something that can be counseled away or by repeatedly pointing out that their genitals do not match their identity or by forcing them to "bunk with the males." Transgender individuals do not need pity from their caregivers. They deserve to be treated with respect (and NO, patients do not have to EARN respect from caregivers who are being paid to take care of them).

children can be diagnosed with gender dysphoria which is ridiculous!

Ridiculous according to whom? You? Who are you? A student? A CNA? You feel qualified to make these pronouncements because you have "talked with victims of gender dysphoria"?

It is a FACT that there are children with gender dysphoria. Many of them insist from the time they can talk that they are NOT the gender that their sex organs would imply. There is no other word for this phenomenon.

Don't tell me to educate myself!

I will tell you to educate yourself, because you are very obviously clearly lacking in education on this subject.

And what are you, 12, using words like "retarded"? I read another post by you where you referred to posts that disagreed with you as "autistic." I really really hope you have no further plans to work in mental health.

There is a thing called a standard of care in nursing. Transgender studies are ongoing, and most of us are in a steep learning curve. But current standard of care advocates respecting the transgender's gender identity by using the pronouns they request, accepting their identity and treating them accordingly. What is NOT standard of care is any behavior which serves to argue with them about their identity. Health care professionals who will not leave their biases at the door have no business working with this patient population. They are at increased risk of suicide partly because of the way they are treated day in and day out by the general public. They should not have to face this kind of treatment from health care PROFESSIONALS.

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Gender dysphoria and being transgendered are not treated as mental illnesses, gender dysphoria previously had a DSM diagnosis but that was removed 6 years ago. Both are the result of variations resulting in inconsistencies in sex and gender development. Just as you might be born with some female anatomy and some male anatomy, you might also be born with conflicting gender identity and anatomical development.

You're making a very outdated assumption that everyone is either all male or all female. If someone should be "treated as the sex and gender they were born as", how do you define that, by chromosomes? External genitalia? Internal reproductive anatomy? What if it's 50/50?

This is the problem right here. Gender is a social construct from what I can gather and Sex is referring to your genitalia. Ok.

"if someone should be treated as the sex and gender they were born as, how do you define that, by chromosomes? External genitalia? Internal reproductive anatomy? What if it's 50/50?"

People have forgotten about 'tomboys' and 'tomgirls' biologically born girls acting boyish and biologically born boys acting girly respectively and hermaphrodites these are outliers.

I understand the concept of people that are born as hermaphrodites and need to have a corrective surgery. Kids grow out of the tomboy, tomgirl stage.

"Just as you might be born with some female anatomy and some male anatomy, you might also be born with conflicting gender identity and anatomical development." What you are saying is ludicrous. If I understand correctly Gender is a social construct or something. What you are saying here (Or how I'm interpreting it) someone is born with a female body but thinks they are male (something that is not true) That is delusional and I was taught to not feed into patient's delusional fantasies.

"outdated assumption that everyone is either all male or all female"

I don't mean to cherry pick you but what does that mean!? Of course there are male and female! What else could there be?

"Gender dysphoria and being transgendered are not treated as mental illnesses, gender dysphoria previously had a DSM diagnosis but that was removed 6 years ago."

What Is Gender Dysphoria?

It should be from the current DSM V of course I may have misquoted should have said disorder.

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People have forgotten about 'tomboys' and 'tomgirls' biologically born girls acting boyish and biologically born boys acting girly respectively and hermaphrodites these are outliers.

I understand the concept of people that are born as hermaphrodites and need to have a corrective surgery. Kids grow out of the tomboy, tomgirl stage.

How is this relevant? Being a tomboy is not the same as gender dysphoria. Tomboys may look or act more traditionally boyish, but if they see themselves as females, they do not have gender dysphoria, regardless of if they play sports or don't like to wear traditionally "girly" clothes.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Please quit calling them "hermaphrodites." That's as gross as using the word "retarded."

The term is "intersexed."

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You do not treat gender dysphoria as a health care professional by refusing to acknowledge their gender identity. You CLEARLY have zero understanding of how gender identity is established in humans; it is not something that can be counseled away or by repeatedly pointing out that their genitals do not match their identity or by forcing them to "bunk with the males." Transgender individuals do not need pity from their caregivers. They deserve to be treated with respect (and NO, patients do not have to EARN respect from caregivers who are being paid to take care of them).

Ridiculous according to whom? You? Who are you? A student? A CNA? You feel qualified to make these pronouncements because you have "talked with victims of gender dysphoria"?

It is a FACT that there are children with gender dysphoria. Many of them insist from the time they can talk that they are NOT the gender that their sex organs would imply. There is no other word for this phenomenon.

I will tell you to educate yourself, because you are very obviously clearly lacking in education on this subject.

And what are you, 12, using words like "retarded"? I read another post by you where you referred to posts that disagreed with you as "autistic." I really really hope you have no further plans to work in mental health.

There is a thing called a standard of care in nursing. Transgender studies are ongoing, and most of us are in a steep learning curve. But current standard of care advocates respecting the transgender's gender identity by using the pronouns they request, accepting their identity and treating them accordingly. What is NOT standard of care is any behavior which serves to argue with them about their identity. Health care professionals who will not leave their biases at the door have no business working with this patient population. They are at increased risk of suicide because of the way they are treated day in and day out by the general public. They should not have to face this kind of treatment from health care PROFESSIONALS.

Ah yes let the condescension rain down. Gender identity is nonsense claiming you can be non-binary or have multiple genders is delusional. You cannot naturally become a male or female from surgery. you can look the part sure.

"Ridiculous according to whom? You? Who are you? A student? A CNA? You feel qualified to make these pronouncements because you have "talked with victims of gender dysphoria"?

It is a FACT that there are children with gender dysphoria. Many of them insist from the time they can talk that they are NOT the gender that their sex organs would imply. There is no other word for this phenomenon."

What Is Gender Dysphoria?

Unlike you I research things it is taken from the DSM V.

"I will tell you to educate yourself, because you are very obviously clearly lacking in education on this subject.

And what are you, 12, using words like "retarded"? I read another post by you where you referred to posts that disagreed with you as "autistic." I really really hope you have no further plans to work in mental health."

What is your point here? I said "autistic" or "retarded"

Are you aware that only trans trenders (a minority of a minority) believe the nonsense that is gender spectrum? And that a lot of the garbage that is being espoused is undermining real transgenders?

"Ridiculous according to whom? You? Who are you? A student? A CNA? You feel qualified to make these pronouncements because you have "talked with victims of gender dysphoria"?

"They should not have to face this kind of treatment from health care PROFESSIONALS."

I love your condescending elitism btw. I love how you reiterate being a professional while doing that when face with a controversial opinion.

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How is this relevant? Being a tomboy is not the same as gender dysphoria. Tomboys may look or act more traditionally boyish, but if they see themselves as females, they do not have gender dysphoria, regardless of if they play sports or don't like to wear traditionally "girly" clothes.

Because people/parents/doctors will think it is dysphoria in kids now.

What Is Gender Dysphoria?

About The Show - I Am Jazz | TLC

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Please quit calling them "hermaphrodites." That's as gross as using the word "retarded."

The term is "intersexed."

My apologies that is a dated word but the only thing I could think of regarding the classic "born with both parts"

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Specializes in Adolescent Psychiatry.

I think a question to really think about is how many people get hurt when you treat people with respect and dignity by using the preferred pronouns and names of a transgender individual? And if people are getting hurt by using someone's preferred pronouns and gender, what is going on with that person that dignity causes them pain? In all honesty it should not cause anyone actual lasting pain to use a set of pronouns and a name, it can however cause damage by refusing to treat someone with dignity by using them. Your posts here are basically trying to rationalize your idea that its ok to treat people like dirt because you don't agree with their choices.

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Specializes in Travel, Home Health, Med-Surg.

Guiding Families of Transgender Children

As with any patient who is in our care it is important to treat them in a caring and respectful manner no matter how you feel personally. As healthcare professionals it is indeed what we signed up for. There are mixed opinions on how to "treat" these individuals. If adults, then up to that individual adult, if a child then obviously more care is needed because biologically their brain is not complete so you would have concerns before doing any surgery etc. Either way, we as healthcare professionals, do not have to like, understand, agree with etc. We just need to be our caring selves while providing nonjudgemental care to all patients.

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Because people/parents/doctors will think it is dysphoria in kids now.

What Is Gender Dysphoria?

About The Show - I Am Jazz | TLC

From your article:

Gender dysphoria is not the same as gender nonconformity, which refers to behaviors not matching the gender norms or stereotypes of the gender assigned at birth. Examples of gender nonconformity (also referred to as gender expansiveness or gender creativity) include girls behaving and dressing in ways more socially expected of boys or occasional cross-dressing in adult men. Gender nonconformity is not a mental disorder. Gender dysphoria is also not the same being gay/lesbian.

Any doctor who works with transgender children will absolutely know the difference between a "tomboy" and someone who has gender dysphoria.

And I would be willing to bet that most parents would be more likely to label their transgender child a tomboy rather than the other way around. Very few parents are quick to embrace the concept of their child being transgender.

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I think a question to really think about is how many people get hurt when you treat people with respect and dignity by using the preferred pronouns and names of a transgender individual? And if people are getting hurt by using someone's preferred pronouns and gender, what is going on with that person that dignity causes them pain? In all honesty it should not cause anyone actual lasting pain to use a set of pronouns and a name, it can however cause damage by refusing to treat someone with dignity by using them. Your posts here are basically trying to rationalize your idea that its ok to treat people like dirt because you don't agree with their choices.

I suggest you reread the posts I made I do not try to justify treating anyone like dirt.

Dr. Leonard Sax in this interview suggests that feeding into delusions like this is malpractice.

"I think a question to really think about is how many people get hurt when you treat people with respect and dignity by using the preferred pronouns and names of a transgender individual?"

A lot of people actually. Dr. Jordan Peterson was affected by this a psychology clinician and professor in Canada lost his job for opposing Bill C16 which declares that if you misgender someone even on accident you will get fined.

I highly suggest you read my posts again I acknowledge that gender dysphoria is an issue and pity people that have it.

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