Question

Regarding gender identity, discuss issues regarding transgender patients (both transgender male and transgender female) and determine appropriate approaches as a registered nurse to address patient needs, ensure quality care, and promote safety.

Answer 1

Transgender

                     Transgender is an umbrella term for persons whose gender identity, gender expression or behavior does not confirm to that typically associated with the sex to which they were assigned at birth.

Issues regarding gender identity in transgender patients

                    Gender identity is the internal and psychological sense of a person as a woman, a man, both, in between or neither. Only the person can determine his/her gender identity. They may express gender in a way that differs from how they feel on the inside. This expression includes the name and pronoun they use, style of dress, voice or hairstyle. Gender expression may be referred to as masculine, feminine or androgynous. Person may change how they express themselves depending on the situation such as at school or work, home alone, out with friends.

                 Sometimes a person experiences so much discomfort or distress because their gender identity and the sex they were assigned at birth are different; they decide to explore medical options like hormone therapy or gender-affirming surgeries. These medical options often provide significant comfort.

                     Many of them have the same emotions and questions that have. The pressure and stress caused by feeling alone and sad can lead to depression. Depression can be mild or severe. In its most severe form, depression can lead to suicide.

Nurse’s Role

a. Understanding the needs of a transgender patient

             Healthcare providers are committed to delivering optimal care to all patients as part of their legal and ethical responsibilities. But fulfilling that commitment requires an understanding of the unique needs of various patient populations, including those who are transgender. Being attended to the needs of transgender patients helps nurses ensure their patients' health requirements are met and reduces their risk of legal liability.

· It's important to understand some basic transgender terminology.

· Know-and follow-the policy related to treating patients fairly; if a professional organization doesn't have such a policy, collaborate with others to create one.

· Privacy is particularly important for transgender patients.

· Ensure transgender patients receive the care they deserve by being knowledgeable about their needs, treating them with respect, and advocating that others treat them with respect as well.

b. Providing quality health care to transgender patients

• Create a welcoming environment for transgender patients; understand that they may have experienced many barriers before reaching you and accessing healthcare can be a vulnerable experience.
• Ask patients what name they'd like to be called and their preferred pronoun; create intake forms that ask about sexual orientation, gender identity, and preferred name/pronoun.
• Don't out patients unnecessarily without their permission.
• Provide transgender sensitive healthcare referrals.
• Include gender identity and expression in all nondiscrimination policies.
• Create gender neutral bathrooms, if possible; if not possible, create a policy that transgender patients can use the bathroom that matches their gender identity.
• Provide transgender sensitive and informed patient education materials.
• Don't ask unnecessarily invasive questions; make sure your questions are related to your patients' healthcare.
• Ask patients what language they'd like used to refer to their body.
• Provide training for all staff members on transgender health and sensitivity.
• Educate yourself and other healthcare providers on current transgender health protocols and standards of care.

c. Promoting safety to transgender patients

                    Nurses and health care support workers have a powerful role to play in affirming the true gender identity of trans people. This can be demonstrated by using pronouns of the patient’s choosing when referring to them.

                  Nurses and health care support workers may also wish to signpost their trans clients and patients to the wide range of voluntary and community-based trans support groups that exist.

                 The good practice guidelines for the assessment and treatment of adults with gender dysphoria state that some of the key factors for ensuring positive health outcomes for trans patients include peer support and mentoring, family support, their image in their new social gender role, speech and language therapy.