Transgender Patients: Updates on Providing Care
Each June, we celebrate Pride Month to support the Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) community. As cultural awareness increases, healthcare professionals have a responsibility to provide diverse, respectful care.
Gender identity relates to how someone feels about and sees themselves inside, regarding social norms about roles, qualities, and attributes, such as masculinity and femininity. Sex assigned at birth refers to the genitalia of the individual, which may or may not be associated with gender identity. Transgender patients are those who identify with a gender that they were not physically assigned at birth.
It is also important to remember that gender identity isn’t necessarily related to sexual orientation. Transgender individuals may identify as lesbian, gay, bisexual, or heterosexual. In addition, the term “transition” means the period of time when a transgender person is learning how to cross-live socially as a member of the sex category they identify with, which may involve changing names and gender on legal documents, and/or medical interventions to physically change sex designation (University of California, San Francisco [UCSF], 2016).
The word transgender may also include different types of gender identities, such as genderqueer (persons who do not completely identify with either gender), or gender nonconforming (persons who express their gender differently than social expectations). Gender nonbinary (GNB) individuals may identify as both male and female, or neither male nor female. Other terms for GNB may include gender fluid, pangender, gender ambiguous, or androgyne, amongst others (UCSF, 2016).
What are The Risks for our Patients?
Individuals who identify as LGBTQ+ are at higher risk for violence, including verbal attacks, harassment, bullying, abuse, and physical assaults. One study demonstrated that sexual and gender minorities (LGBTQ+ community) are almost three times more likely to be a victim of a violent crime than individuals who are not (Flores et al., 2020). LBGTQ+ youth are three times more likely to have suicidal ideation, and five times more likely to actually attempt suicide (The Trevor Project, 2021). Transgender individuals also have a lower ability to obtain insurance, higher risk of being a victim of violence or sexual assault, increased risk for drug abuse, higher risk of infections such as sexually-transmitted diseases and human immunodeficiency virus, decreased social support and increased incidents of mental health disorders (American Medical Student Association, 2019).
How Can Nurses Support our Patients?
Have open discussions with your patient. What is their preferred name? What pronouns do they wish to be used? Pronouns are those terms in which a person would like to be addressed. Terms may include he/him, she/her, or they/them, as well as others. We need to show caring and respect by asking how a patient would like to be addressed and honoring that each and every time.
When caring for transgender patients, assessments should include identifying the potential risks that they might have, including emotional, social, and financial concerns, so that they may be addressed. Each of us also needs to understand our own actual or potential bias. Whether prejudices of a healthcare professional are known or unknown, these can cause delays, inappropriate medical care, or other health disparities (American Medical Student Association, 2019). Knowledge about the medical care required for transitioning patients, such as hormone therapy and surgery, is also necessary (UCSF, 2016).
It is important to gain awareness and understanding of the population of transgender patients and to provide culturally sensitive care. Ask the questions. Have the conversations. Learn as much as possible. We can provide the support that our patients need, and help them with better outcomes and improved quality of life.
View the original RN.com article Transgender Patients: Considerations for Care. For more information on providing culturally competent care across healthcare populations, take this course on RN.com, Cultural Competence.
References:
American Medical Student Association. (2019). Transgender health.
Flores, A., Langton, L., Meyer, I., & Romero, A. (2020). Victimization rates and traits of sexual and gender minorities in the United States: Results from the National Crime Victimization Survey, 2017. Science Advances, 6(40), 6910.
The Trevor Project. (2021). Facts about suicide.
University of California, San Francisco. (2016). Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people.
