Care of the Transgender Patient Flashcards
LGBTQ/LGBTQIA
- Lesbian
- Gay
- Bisexual
- Transgender
- Queer/Questioning
- Intersex & asexual &/or ally
Queer was previously derogatory but is now used to reflect more politicized & diverse understanding of sexual orientations as well as gender identities within the LGBTQ+ communities
- There’s a need to improve the healthcare of transgender pts
> Healthy People 2020
> IOM’s report on LGBT health
> Joint Commission field guide for care of LGBT pts
> World Professional Association for Transgender standards of care
- ANA Code of Ethics
- Nurses practice w/
> compassion
> respect for dignity
> worth of every pt
Jean Watson
> Her theory is based on helping pts achieve wellness, as well as harmony within mind, body & soul
Our goal as nurses is to help our pts reach this wellness & harmony
Theory also involves practicing kindness, cultivating one’s own spiritual practice & a moral commitment to protect & enhance human dignity
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Is discomfort w/one’s natal sex
Gender dysphoria
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Is a person’s inner sense of maleness or femaleness; not r/t reproductive anatomy
Gender identity
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This is a person’s genital anatomy present @ birth
biological (natal) sex
Terms
- Transgender Female (MTF)
- Transgender Male (FTM)
- Nonbinary
- Cisgender
- Gender fluid
- Gender neutral
- Gender variant
Use of the proper pronoun
> Show respect to the pt
If you forget to use the proper pronoun, apologize & correct yourself
Psychosocial stressors
> Job discrimination
Bias-related harassment
PTSD
Depression
Can lead to suicidal ideation or suicide attempt
Other stressors
> Lack of health insurance (if unemployed), or denial of coverage for gender transition (if insured)
Lack of healthcare professional knowledge
Prior negative experience w/HCP’s
Assessment
> Ask the pt how he or she would like to be addressed
Respect the pt, use the correct pronoun
History
- h/o interventions, or plans to use in the future
- drug therapy
- surgical hx
Physical assessment
- conduct w/cultural sensitivity, nonjudgmental approach, respect
- explain why exam is important to their healthcare
- Bottom surgery (to the genitalia) or top surgery (to the chest area)
- Gender confirmation surgery alters an individual’s appearance to the reflected, preferred gender
Nursing Care
- Care is often the same as for any other pt
- Advocate for transgender pts
- Provide health teaching
Treatments
Nonsurgical management
- drug therapy
- reproductive health options
- voice & communication therapy
Surgical management
- gender (or sex) reassignment surgery (SRS)
- preoperative, operative, & postoperative care
Education
- hormone therapy
- follow-up care (after procedure, long-term)
- support systems & coping strategies
- community resources
Violence
- 1 in 10 physically attacked in the past yr & 1/2 of all are survivors of sexual violence
- “…face discrimination & violence throughout society, from their family growing up, in school, @ work, by homeless shelters, by doctors, in ERs, before judges, by landlords, & even police officers”
- There is a need for education for students, nurses, practitioners
> Education of nurses is one of the common statements
> Transgender individuals would like to see education & be involved
> In addition to the pts we see in acute care settings as well as outpt settings, there’s an aging population that will need long-term care
- Need our support & understanding
! There’s a lot of misinformation out there
> Many TG individuals know @ an early age
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Refers to individuals that are unable to match their sex @ birth but do not identify themselves as male or female
Nonbinary
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Describes a changeable gender or an individual who may shift between the genders
Gender fluid
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Is not specific or restricted to any particular gender
Gender neutral
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Is displaying gender traits that do not fit the typical male or female models
Gender variant
