A recent report chronicling the “humiliating” experience of a transgender man has encouraged a call to action for ED nurses to be more sensitive when treating transgender patients.
The research, published online Sept. 28 in the Journal of Emergency Nursing, tells the story of patient “Brandon James” (not his real name) and his visit to a U.S. emergency department. The chronicle of James’ experience outlined various situations a transgender patient might encounter in the ED, according to a news release from the Emergency Nurses Association.
James, a masculine transgender man who transitioned with hormone replacement therapy five years before arriving at the ED in 2011, showed his driver’s license identifying him as female. Electronic medical records also included female gender markers for James.
The result was a “humiliating” check-in experience, according to James, who reported staff debating his gender aloud, the news release said. “It wasn’t business-like at all,” James said in the news release. “I was a spectacle. I was a freak show at the circus. It was definitely to draw my attention to the fact that my outward appearance didn’t match [my identification].”
A 2011 study by the National Gay and Lesbian Task Force and the National Center for Transgender Equality found that 19% of respondents reported being refused medical care because of their transgender or nonconforming status. That survey also found half of respondents said they had to teach their medical providers about transgender care, with 28% of study participants saying they postponed care because of discrimination.
In the wake of the Journal of Emergency Nursing report, authors recommend the following approaches nurses should take when treating transgender patients:
• Ask transgender patients how they would like to be addressed.
• Use proper pronouns. Nurses should use the pronoun that matches the gender to which the patient identifies, according to the news release.
• Remain clinical in conversations. Only clinically relevant questions should be asked by nurses when examining a transgender patient.
• Be aware of shared spaces. Study authors say nurses should remain particularly sensitive about using the gender the patient identifies with when taking that patient to an area where they might share space with another patient.
• Lead by example. According to the news release, nurses being on the front lines of ED patient care have an opportunity to take a leadership role in showing respect to all patients regardless of how they identify.
“This patient’s story identifies new implications for emergency nursing practice when treating a transgender patient,” ENA president Matthew F. Powers, MS, BSN, RN, MICP, CEN, said in the news release. “Emergency nurses are on the front lines of treating more and more transgender patients. All patients must be treated with dignity and respect. We want nurses and their ED colleagues to understand how to give these patients the care and respect they deserve.”
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