Nursing Care of the LGBTQI Patient

Students at Barnes-Jewish College Goldfarb School of Nursing attended a panel discussion about nursing care for lesbian, gay, bisexual, transgender, queer or questioning, and intersex (LGBTQI) patients. On Thursday, June 23, approximately 200 students from Barnes-Jewish College Goldfarb School of Nursing attended a panel discussion about nursing care for lesbian, gay, bisexual, transgender, queer or questioning, and intersex (LGBTQI) patients.
 
The discussion was an open forum, and many students asked questions of the panelists, which included four transgender individuals and one intersex individual. Intersex refers to a person who is born with a reproductive or sexual anatomy that doesn’t fit the typical definitions of male or female. For example, a person might be born appearing to be male on the outside but has mostly female-typical anatomy on the inside.
 
“Our society is made up of people of diverse races, ethnicities, genders and cultures,” said Gretchen Drinkard, PhD, RN, interim dean at Goldfarb School of Nursing. “Goldfarb recognizes the importance of teaching our nursing students about diversity before they enter the workplace, where they will face patient care situations that demand sensitivity.”
 
Nurses are in close contact with patients and they often find themselves acting as the patient’s advocate, which can greatly improve that patient’s experience with the healthcare system. When a nurse spends just a few minutes focusing on the patient, they are more likely to generate trust, patients are more likely to follow instructions and healthcare outcomes improve.
 
“Nurses play a huge role in the care of the patient,” added Dr. Drinkard. “They are often the first to meet the patients, to comfort the patients and family and to educate patients about next steps to better health and recovery.”
 
The school’s philosophy is that all patients should be treated with dignity and respect. “It’s our goal at the school to expose students to all the different scenarios they may see when they get in the working world. Their job will include taking care of all types of people in society,” explains Michael Ward, PhD, RTR, FASRT, vice dean for student affairs and diversity at Goldfarb School of Nursing, who coordinated the panel discussion.
 
Dr. Ward adds, “Nurses are on the front lines of treating more and more transgender and intersex patients. We want our nursing students to understand how to give these patients the care and respect they deserve, and that’s why we feel it is important to include information about the care of the LGBTQI population into our general nursing education.”
 
According to TravelNurse Source, here are some tips nurses should note when caring for transgender patients:
1. Ask with what gender they identify
When seeing a new patient (or even an existing patient you haven’t seen in a while), be careful not to hastily pass assumptions on their gender identity solely based on masculine or feminine cues. To avoid slip-ups, immediately ask each patient with which gender they identify.
2. Don’t mix up pronouns
After asking a patient about the gender they identify with, refer to them using the correct pronoun (“he” for male and “she” for female), or you can use a gender-neutral alternative. Either way, it’s crucial to be consistent and mindful of the gender-identifying terms used when referring to a patient.
3. Check their registration before asking their gender identity
Check to see if the patient identified a specific gender on their registration forms. If so, you can skip #1 altogether and move on to caring for the patient with no further discussion about gender.
4. Keep to clinical questions solely
If you’re not familiar with the transgender lifestyle, it may be confusing and raise questions. However, keep your interactions professional and sensitive. If you are asking questions, ensure that they are related to treatment.
5. Screen for gender dysphoria
Although a lot of transgender individuals have a positive self-identity, others do not. So if you’re treating a patient who is harboring negative feelings about their gender-identity, it is important as a healthcare provider to guide those who may be struggling with feelings of uncertainty in a positive direction. Suggest that they visit websites such as World Professional Association for Transgender Health (WPATH) or the Gay and Lesbian Medical Association, or if appropriate, that they seek counseling.
6. Gender-specific health prevention shouldn’t be ignored on a transgender patient
Although you should treat a patient’s gender identification delicately, you cannot ignore biological health checkups. For example, if a transgender man still has female anatomy, they should still have Pap tests. Also, just like any other patient, transgender patients should still be screened for STIs and be provided information about contraception.
7. Remember that being transgender is not a psychological choice
Evidence has shown that being transgender is not a choice, but rather, it is rooted in biology. Nurses should only suggest counseling if the patient’s emotional state puts them at risk.