Informed Consent Vs. The Gatekeeper Model Essay

Informed Consent is defined as consent by a patient to undergo a medical or surgical treatment or to participate in an experiment after the patient understands the risks involved. (wordnetweb.princeton.edu/perl/webwn 2011) This concept is based in general on a patient’s right to self-determination when given adequate disclosure of a specific treatment plan.

Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed

Scholars have been critical of the medical establishment’s and state’s involvement in constructing and policing of transgender identity. These kinds of pressing issues have occupied the small existing literature. There is not much information and studying what is being done on transgender in traditional areas, family studies research, such as their dating behavior and formation of intimate relationships in adulthood. There is little research on the issues around being parents, their children’s experiences with having transgendered parents, as well as relationships in the family as a whole, and relationships in work and school.

Perhaps the most significant contributing cause of the poor quality of healthcare afforded to transgender patients is the fact that the majority of healthcare providers do not know how to treat trans patients. According to a study done by the Royal College of Nursing, it was discovered that “78% [of surveyed nursing staff] had not had training on how to care for transgender people, and only 13% of those surveyed said they had felt prepared to meet the needs of trans patients they had cared for” (Duffy, 2016). Additionally, around four out of five staff had “no training

Topics concerning transgender can be very overwhelming for some. When one thinks of the term transgender, one may think of the process of an individual identifying as the opposite sex. The opposite sex of what he or she was born as. For some, this may involve undergoing surgical procedures or taken hormonal medications to fulfill their desire. However, when thinking of this process, one automatically thinks of transgender adults. This is rarely a topic that one would assume would be racing through the minds of young children, but in fact it is. More children today than ever, are either speaking out about their identity concerns, or displaying it in their lives. In fact, according to Date Line NBC, “The handful of American doctors who specialize

The transgender population often have complicated medical needs and encounter numerous health disparities including discrimination, lack of access to quality health care and social stigma. Some health disparities include various chronic diseases, cancers, as well as mental health issues (Vanderbilt University, 2017). Transgender individuals are at increased risk of HIV infection with their rates being reported “over four times the national average of HIV infection, with higher rates among transgender people of color (Grant, Mottet, Tanis, 2011).” In addition, they usually do not have health insurance (Makadon, 2017) and have a lower probability of preventative cancer screenings in transgender men (AMSA, 2017).

With the establishment of these gender identity clinics, and the financial backing of philanthropist Reed Erickson, a transsexual man, the health care needs of transsexual people gained increased attention and support. Despite this new attention, the clinics used Benjamin’s model of “true” transsexuals. This differentiation between “true” transsexuals and other gender variants became a serious and highly important diagnostic decision as gender affirming surgeries were irreversible. This resulted in many transsexual individuals to be denied access to hormones and surgery. Specifically, transsexual men encountered difficulties, as transsexuality was primarily seen as a male-to-female only transition. In fact, during the late 1960s the United States leading UCLA Gender Identity Research Clinic debated whether trans men should be considered transsexuals. Many trans men themselves did not label themselves as transsexuals as they only knew about other transsexual women (Meyerowitz, 2002; Beemyn, 2014).

Lesbian, Gay, Bisexual, and Transgender (LGBT) falls within societal minority groups such as low income, people of color, and disables (AHRQ, 2011). Due to their gender identity, discrimination, violence, and even denial of human rights and healthcare services is a common challenge among LGBT population. LGBT still faces many health disparities primarily related to the historic bias of healthcare professionals anti-LGBT manners even though society acceptance has been favorable. According to Ard and Makadon (n.d), “until 1973, homosexuality was listed as a disorder…, and transgender still is.” This stigma prevents healthcare professionals to openly ask questions in a non-judgmental manner related to sexual identity. On the other hand, if the patient senses that the healthcare environment is discriminating they may be reluctant to disclose important information as their sexual orientation; thus, missing important opportunities of been educated about safety and health care risks.

In step two, the trans person must openly live as their identified gender for about two years which includes dressing, speaking and operating like their identified gender, beginning a hormone treatment and sometimes cosmetic surgery, at their own cost, if desired. There are many transgender people who are content with living the rest of their lives in step two, but if a medical professional deems it medically necessary for the trans person’s health and they (the trans person) is confident in themselves, the third and final step is sex-reassignment surgery. Per Agbemenu, SRS consists of “vaginoplasty for trans females and phalloplasty for trans males”. Now, with a better understanding of gender dysphoria and sex-reassignment surgery, one may better understand opposing arguments.

There are three themes in this statement given, which include health management, patient safety and discharge planning. The main focus of the article involves care for HIV diagnosed transgender within the correction system (Phillips & Patsdaughter, 2010). Transgender experiences involve maintaining their health following their HIV diagnosis and continuing their physical transition process. Health management “policies that attempt to freeze gender transition at the stage reached before incarceration are inappropriate and out of step with medical standards, and therefore should be avoided” (Phillips & Patsdaughter, 2010, p. 184). This above statement supports maintaining the transitional process as a standard of care for transgender individuals.

Sexuality and gender identity issues have had a long history in the fields of mental health and public policy. There has been much debate surrounding the inclusion of issues related to gender and sexual identity in the Diagnostic and Statistical Manual since its initial stages of development (Drescher, 2010). Debates in this field of interest have been fragmented between several stakeholders (Ehrbar, 2010). This fragmentation has created complications in the process of developing United States policies that are inclusive of individuals with gender identities that do not match the gender to which they were assigned at birth. Specifically, policies surrounding gender reassignment surgeries have been difficult to develop and

Training classes will help nurses to understand the definitions and terms, being empathic to transgender individuals in prison, and provide gender-affirming healthcare services (Wahowiak, 2016). It is also important to note what led them to become incarcerated so that as a nurse you can help prevent them from being incarcerated again. Treating transgender individuals with “fairness, dignity, and respect” is extremely important because that is how you develop a nurse-patient relationship (NCCHC, 2015). Patient safety will also have an impact on the profession of nursing as our mission is to protect, heal, and advocate for our patients regardless of their gender identity. Transgender inmates are at risk for violence and sexual assault or harassment. As nurses, it is our duty to ensure that while they are incarcerated they are being treated equally, receiving the same healthcare treatment as others and that we report any incidents. Housing should also be addressed so that they can be housed based on their gender-identity instead of their genitalia. Previously mentioned, transgender individuals are denied their medication because the healthcare system is indifferent to their needs and views it as unimportant compared to the rest. In spite of this, what they fail to see is that if they keep denying them their medications and sex reassignment surgery, they become more liable because it will lead to self-castration or mutilation. As a result, they become responsible for what happens in prison and if they become ill from catching an infection due to self-castration the health professionals become questionable. Questionable in the sense of, if it could have been prevented and where did the staff fail in providing

Sexual and social stigmas largely affect the health of the lesbian, gay, bisexual and transgender (LGBT) population. While many reports from the Institute of Medicine, Healthy People 2020 and the Agency for Healthcare Research and Quality recognize a need to improve the quality of health care, barriers still remain. LGBT patients face legal discrimination, especially with insurance, a lack of social programs, and limited access to providers competent in LGBT health care. Although the Affordable Care Act increased access to care for LGBT patients, unless these patients feel understood by providers and develop trust in the system, they are not likely to utilize care. Healthcare providers need to recognize how these vulnerabilities, as well as persistent racism and stigma linked to sexual orientation and gender identity, make the healthcare needs of LGBT patients more challenging than the general population. Healthcare providers also need to promote cultural competence within this population and broaden their clinical lens to include health promotion, in addition to addressing concerns mentioned above within the population. Additionally, medical and nursing schools need to ensure that future providers are adequately educated by including information about this population in the curriculum.

LGBT patients facing discrimination in the health care are completely unethical, immoral and a violation of their civil right. The WHO, constitution enshrines “the highest attainable standard of health as a fundamental right of every human being”. According to a 2010 report by Lambda Legal, 70 percent of transgender respondents had experienced severe discrimination in the health care.

Following the landmark supreme court ruling in favor of same sex marriage in 2015, the issue of further LGBT protections has become a common concept of debate within the United States. Many politicians have an unfortunately uninformed and nuance lacking stand on the concept, and only 15 states have comprehensive anti-discrimination protections for transgender people. Louisiana, in fact, repealed a non-discrimination bill in 2016 under governor Bobby Jindal. As a topic of debate, there are a variety of factors that play into the acceptance of transgender (herein, trans) people, despite the nearly unanimous agreement of the medical community in favor of trans rights.