Caring for the Transgender Person

About this course

In recent years, increasing awareness and recognition of diverse gender identities have highlighted the importance of healthcare professionals being well-versed in the care of transgender individuals. This is particularly important as an estimated 2.6 million Americans identify as transgender, accounting for 1% of the nation's adult population. This course examines the facets of competent care for transgender individuals, covering definitions, psychosocial challenges faced by this population, and terminology. It also discusses available therapies, such as hormone replacement therapy and surgical interventions, in addition to nursing considerations to enhance inclusivity in a healthcare setting.

Learning objectives

• Define gender identity as is relates to the transgender person.
• Recognize discrimination that the transgender person may experience in gaining employment, housing, and access to healthcare.
• Review hormone replacement therapy and surgical interventions for gender affirming care.
• Understand current federal legislation and how state laws may vary regarding transgender care.
• Review nursing considerations for providing care to a transgender person in a healthcare setting.

Course outline

13 sections · finish in any order across devices

1. 1

   Introduction

   In recent years, increasing awareness and recognition of diverse gender identities have highlighted the importance of healthcare professionals being well-versed in the care of transgender individuals. This is particularly important as an estimated 2.6 million Americans identify as transgender, accou

   4 min

2. 2

   Defining Gener Identity

   Gender identity lies at the core of the transgender experience. Conventional gender identity is built on biological sex, which is the classification of people as male, or female based on physical genetics and physiological attributes. These include chromosomes (XY for male and XX for female), reprod

   4 min

3. 3

   Defining Gender Dysphoria

   Gender dysphoria is a psychological term used to describe the distress that may arise when a person's gender identity does not align with the sex assigned to them at birth. It is important to emphasize that gender dysphoria is not synonymous with being transgender, as there are transgender people wh

   4 min

4. 4

   Transgender Population Statistics

   Transgender people often experience significant health disparities, including higher rates of mental health issues, substance abuse, and suicide attempts compared to the general population, which is attributable to societal stigma, discrimination, and a pervasive lack of understanding. The heightene

   5 min

5. 5

   Gender Identification Terminology

   Given below are the prevalent terms used to describe gender identity. These terms may be subject to change as language around gender identification continues to evolve. A person who identifies with the biological sex assigned to them at birth is referred to as cisgender. A person born as male identi

   4 min

6. 6

   Gender-Affirming Care

   Gender-affirming care refers to medical, psychological, or social interventions and support provided to transgender people to help align their physical appearance, gender identity, and overall well-being with their affirmed gender. The goal of gender-affirming care is to enhance the individual's men

   4 min

7. 7

   Maintaining Confidentiality

   Like all patients, transgender patients have a right to privacy regarding their personal information, including their gender identity and medical history. Respecting confidentiality reinforces trust between healthcare providers and patients. Trust is a foundational element in the patient-provider re

   4 min

8. 8

   Providing Support

   To establish unbiased and inclusive care, healthcare providers must offer support and treat transgender patients like any other. It is well-documented that transgender individuals face systemic barriers to accessing adequate healthcare, resulting in serious health consequences. Most insurance polici

   4 min

9. 9

   Types of Hormone Replacement Therapy

   Hormone replacement therapy (HRT) for transgender adults involves the use of hormones to promote physical changes in secondary sex characteristics that align with their gender identity. The specific hormones vary and are based on whether someone is undergoing feminizing or masculinizing HRT, along w

   4 min

10. 10

    Surgical Interventions

    Transgender individuals may choose to undergo surgical intervention to align their physical characteristics with their gender identity, helping reduce the incongruence between their body and sense of self. However, like all surgical procedures, these interventions carry inherent risks and potential

    7 min

11. 11

    Federal Legislation on Transgender Rights and Healthcare

    There have been several federal and state-level initiatives aimed at protecting transgender rights, including those related to healthcare. It is important to note that legislation can change, and new laws may be enacted in the future. Key federal legislation and policies, such as the Patient Protect

    4 min

12. 12

    Nursing Considerations

    Nursing considerations for treating transgender patients involve a multifaceted approach encompassing both clinical and psychosocial aspects. Establishing a culturally competent and non-discriminatory environment is foundational. Nurses with limited experience can improve inclusivity by consistently

    4 min

13. 13

    Conclusion

    Providing comprehensive care for transgender individuals involves a multifaceted approach that extends beyond medical interventions. It covers an in-depth understanding of the nuances of gender identity, respecting individuals' autonomy, and recognizing the diverse paths individuals may take in thei

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• What percentage of the US population is transgender? (2023, August 3). USAFacts. https://usafacts.org/articles/what-percentage-of-the-us-population-is-transgender/
• Klein, D. A., Paradise, S. L., & Goodwin, E. T. (2018). Caring for Transgender and Gender-Diverse Persons: What Clinicians Should Know. American Family Physician, 98(11), 645–653. https://www.aafp.org/pubs/afp/issues/2018/1201/p645.html
• December 2016 THE REPORT OF THE. (n.d.). https://transequality.org/sites/default/files/docs/usts/USTS-Executive-Summary-Dec17.pdf
• Crowley, D., Cullen, W., & Van Hout, M. C. (2021). Transgender health care in primary care. The British Journal of General Practice, 71(709), 377-378. https://doi.org/10.3399/bjgp21X716753
• Pinna, F., Paribello, P., Somaini, G., Corona, A., Ventriglio, A., Corrias, C., Frau, I., Murgia, R., El Kacemi, S., Galeazzi, G. M., Mirandola, M., Amaddeo, F., Crapanzano, A., Converti, M., Piras, P., Suprani, F., Manchia, M., Fiorillo, A., & Carpiniello, B. (2022). Mental health in transgender individuals: a systematic review. International Review of Psychiatry, 34(3-4), 292–359. https://doi.org/10.1080/09540261.2022.2093629
• Wesp, L. M., Malcoe, L. H., Elliott, A., & Poteat, T. (2019). Intersectionality Research for Transgender Health Justice: A Theory-Driven Conceptual Framework for Structural Analysis of Transgender Health Inequities. Transgender Health, 4(1), 287-296. https://doi.org/10.1089/trgh.2019.0039
• Fouché, T. W., Zakrison, T. L., Schneider, J. A., Kaufman, E. J., Plackett, T. P., Velopulos, C., Slidell, M. B., Voisin, D., Hampton, D. A., Carmichael, H. E., Valdés, D. M., Parker, C., Ross, B., Chaudhary, M., & Cirone, J. (2022). Demographic and Regional Factors Associated With Reporting Homicides of Transgender People in the United States. Journal of Surgical Research, 279, 72-76. https://doi.org/10.1016/j.jss.2022.05.029
• Flores, A. R., Meyer, I. H., Langton, L., & Herman, J. L. (2021). Gender Identity Disparities in Criminal Victimization: National Crime Victimization Survey, 2017–2018. American Journal of Public Health, 111(4), 726-729. https://doi.org/10.2105/AJPH.2020.306099
• Dinno, A. (2017). Homicide Rates of Transgender Individuals in the United States: 2010–2014. American Journal of Public Health, 107(9), 1441-1447. https://doi.org/10.2105/AJPH.2017.303878
• Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innovations in Clinical Neuroscience, 19(4-6), 23-32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341318/
• Transgender Health | Endocrine Society. (n.d.). Www.endocrine.org. https://www.endocrine.org/advocacy/position-statements/transgender-health
• Milionis, C., & Koukkou, E. (2023). Barriers and Challenges in Caring for Transgender People: Implications for Clinical Practice and the Experience From a Specialized Center. Journal of Doctoral Nursing Practice, 16(1), 44–53. https://doi.org/10.1891/JDNP-2021-0022
• Radix, A. (2019). Hormone Therapy for Transgender Adults. Urologic Clinics of North America, 46(4), 467-473. https://doi.org/10.1016/j.ucl.2019.07.001
• Standards of Care - WPATH World Professional Association for Transgender Health. (2012). Www.wpath.org. https://www.wpath.org/publications/soc
• Hembree, W. C., T, P., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V., & G, G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869-3903. https://doi.org/10.1210/jc.2017-01658
• Prior, J. C. (2019). Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Ciswomen. The Journal of Clinical Endocrinology & Metabolism, 104(4), 1181-1186. https://doi.org/10.1210/jc.2018-01777
• Lai, A., & Johnson, R. (2023). World professional association for transgender health guidelines: 2022 surgical treatment updates in the standards of care for transgender and gender diverse people. Neurourology and Urodynamics, 42(5), 900-902. https://doi.org/10.1002/nau.25099
• Elias, N., Rysin, R., Kwartin, S., & Wolf, Y. (2022). Breaking the Binary: The Approach to Chest Masculinizing Gender-Affirming Surgery in Trangender Men. The Israel Medical Association Journal, 24(1), 20–24. https://europepmc.org/article/med/35077041
• Patel, H., Samaha, Y., Ives, G., Lee, Y., Cui, X., & Ray, E. (2021). Chest Feminization in Male-to-Female Transgender Patients: A Review of Options. Transgender Health, 6(5), 244-255. https://doi.org/10.1089/trgh.2020.0057
• Al-Tamimi, M., Pigot, G. L., Elfering, L., Özer, M., de Haseth, K., van de Grift, T. C., Mullender, M. G., Bouman, M.-B., & Van der Sluis, W. B. (2020). Genital Gender-Affirming Surgery in Transgender Men in The Netherlands from 1989 to 2018. Plastic and Reconstructive Surgery, 145(1), 153e161e. https://doi.org/10.1097/prs.0000000000006385
• Li, V. Y., Demzik, A., Snyder, L., Ogunleye, A. A., Wang, A., & Figler, B. D. (2022). Genital Gender Affirming Surgery. The American Surgeon. https://doi.org/10.1177_00031348221109479
• Chen, M. L., Reyblat, P., Poh, M. M., & Chi, A. C. (2019). Overview of surgical techniques in gender-affirming genital surgery. Translational Andrology and Urology, 8(3), 191-208. https://doi.org/10.21037/tau.2019.06.19
• Asokan, A., Sudheendran, M. K., Mohandas, M., George, P. S., & Nair, R. M. (2023). Facial Feminization Surgery: Preoperative Planning and Surgical Technique for a Harmonious Outcome. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 56(4), 298-309. https://doi.org/10.1055/s-0042-1759692
• Galbraith, L. G., Schnall, M., & Aultman, J. M. (2023). Facial Feminization Considerations for the Transgender Patient. Plastic and Reconstructive Surgery Global Open, 11(4). https://doi.org/10.1097/GOX.0000000000004933
• Van Boerum, M. S., Salibian, A. A., Bluebond-Langner, R., & Agarwal, C. (2019). Chest and facial surgery for the transgender patient. Translational Andrology and Urology, 8(3), 219-227. https://doi.org/10.21037/tau.2019.06.18
• Bannister, J. J., Juszczak, H., Aponte, J. D., Katz, D. C., Knott, P. D., Weinberg, S. M., Hallgrímsson, B., Forkert, N. D., & Seth, R. (2022). Sex Differences in Adult Facial Three-Dimensional Morphology: Application to Gender-Affirming Facial Surgery. Facial Plastic Surgery & Aesthetic Medicine, 24(Suppl 2), S-24. https://doi.org/10.1089/fpsam.2021.0301
• Aires, M. M. (2021). Chondrolaryngoplasty in transgender women: Prospective analysis of voice and aesthetic satisfaction. International Journal of Transgender Health, 22(4), 394-402. https://doi.org/10.1080/26895269.2020.1848690
• Pansritum, K. (2021). Forehead and Hairline Surgery for Gender Affirmation. Plastic and Reconstructive Surgery Global Open, 9(3). https://doi.org/10.1097/GOX.0000000000003486
• Asokan, A., & Sudheendran, M. K. (2022). Gender Incongruence: Gender Affirming Body Contouring and Physical Transformation in Transgender Individuals. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 55(2), 179-187. https://doi.org/10.1055/s-0042-1749099
• The White House. (2022, March 31). FACT SHEET: Biden-Harris Administration Advances Equality and Visibility for Transgender Americans. The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/31/fact-sheet-biden-harris-administration-advances-equality-and-visibility-for-transgender-americans/
• Hassan, A. (2023, June 27). States Passed a Record Number of Transgender Laws. Here’s What They Say. The New York Times. https://www.nytimes.com/2023/06/27/us/transgender-laws-states.html

Update history