Transgender Community

Prisoners that are incarcerated go through many hardships during the course of their sentence. The mistreatment that inmates in prison encounter is unjustifiable in many cases. Amongst the inmates mistreated, transgender prisoners are challenged in many ways with abuse, misconduct, and discrimination. Transgender individuals are people who do not identify themselves with the gender that was assigned at birth. The high-risk profile of being a transgender inmate in prison strikes for deep concern and something needs to be done.

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.

Regarding access to healthcare, transgender individuals often face the most obstructive barriers when attempting to receive care. Whether they are seeking access to hormones, therapy, general health services, reproductive healthcare, or specialty healthcare, transgender patients typically cannot get what they need without jumping through many hoops or hiding their identities. This occurs especially so in cases of intersecting identities -- where an individual is not just transgender, but is transgender and a person of color, disabled, gay, indigenous, undocumented, poor, etc. These intersecting identities interact in multifaceted ways to produce even more barriers for trans individuals seeking healthcare due to healthcare provider bias, insurance requirements, and doctors’ general unwillingness to help coupled with inaccessibility founded on racism, transphobia, homophobia, mental illness stigmatization, etc.

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).

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.

Evidence-informed practice is a critical part of nursing care. To be able to have evidence-informed practice, nurses need to be able to conduct research to find the most up-to-date and relevant information related to patient- and family centered care. When caring for patients, it is paramount to recognize the importance of family and the role they play in care. When one comes out as transgender, it is something that is not only going to affect the said person, but also their friends and family. Family members are key support systems so when you are caring for one person, you are in turn caring for the family as well. This is known as patient- and family-centered care. As there has been an increase in literature pertaining to family-centered care, the question of interest is “What is the impact on a spouse when a partner is transgendered?” To find the answer to this clinical question, the database Medline was utilized. The keywords LGBTQ, transgender, family-centered, spouse, nurse, sexuality and health care were used and combined with Boolean operators. Through this research, knowledge can be gained on how to properly care for the spouse of a transgendered person. This paper will discuss the key impacts of having a transgender spouse, nursing approaches that we can integrate into our care, and resources available for the non-transgender spouse.

Of the study’s 25 participants, 20 were female-to-male. The authors determined the main problem for the participants was the struggle to find transgender-sensitive health care. The subjects described discrimination by healthcare systems, lack of knowledge and hostility by providers, and lack of health insurance to cover transgender-specific healthcare needs. Some of the FtM participants who had problems with pelvic pain, abnormal uterine bleeding, and a history of abnormal Pap tests kept their gender as female on their insurance so they could still get the care they needed. Using a national cross-sectional survey data set, Shires and Jaffee (2015) reported similar findings. Of the 1,711 FtM participants included in this study, 41.8 percent reported verbal harassment, physical assault, or denial of equal treatment in a doctor’s office or

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

While things like marriage and anti-discrimination laws have made it safer and more accepting in the mainstream for lesbian, gay, and bisexual people, the transgender community remains largely unchanged by these things. One area in particular has remained almost completely stagnant since the 1980s, medicine. Most medical professionals willing to aid transgender individuals in Hormone Replacement Therapy (HRT) and Sexual Reassignment Surgery (SRS) operate under the gatekeeper model. The gatekeeper model is loosely defined as the practice where any combination of doctors, therapists, and psychiatrists take the majority of responsibility for the diagnosing and, “treatment,” of a transgender person seeking either HRT or SRS. Under this model nearly sole responsibility falls to that group of professionals, and because of that many problems in terms of proper diagnosis, ethics, and safety have sprung up. More recently a very small amount doctors have been operating under a new model. This model, called informed consent, allows the transgender individual to take some responsibility for their treatment, and in a lot of cases subvert the massive amount of unreasonable hoops and rules the gatekeeper model has. The informed consent model of treatment for transgender individuals is the superior model by far in terms of diagnosis, safety, and ethical treatment.

For many individuals in the LGBTQ+ community, finding healthcare professionals who understand their identities and are receptive to their needs can be difficult. Many in the community feel that they have difficulties finding a practice that will respect their identity and provide them with effective and reliable care. For those specifically in the transgender community, these difficulties can increase exponentially, as many doctors are not properly trained to address the specific health needs that transgender individuals can often require. By his senior year, recent Keene State College graduate Kennedy Redden had noticed that both the staff of his school’s health center and the nearby Planned Parenthood had a distinct lack of knowledge about the needs of transgender students. Because of this, Kennedy decided to write a Transgender Health Manual for the school to use in the general education of its healthcare professionals as his senior capstone piece in Community Health.

In addition, the individual may not have access to affordable health care coverage for a variety of reasons, including joblessness and poverty (Xavier, 2000; Xavier, Hitchcock, Hollinshead, Keisling, Lewis, Lombardi, & Williams, 2004). Furthermore, transgender clients may be concerned about outing themselves to a health care provider because of the stigma associated with being transidentified (Munson, 2008). The combination of prohibitive costs with high rates of unemployment results in a major institutional barrier to care for transgender populations.

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.

According to Hagg and Fellows (2007:4), sex generally refers to anatomy and biology such as male or female, whereas gender refers to the qualities and behaviours society expects from a boy or girl, a man or woman. The definition of transgender refers to a person having no identification with, or no presentation as, the gender one was assigned at birth (Hagg and Fellows 2007:4). The definition of transsexual in Hagg and Fellows (2007:4) refers to a person who had undergone a sex change operation or a person identifying with the opposite sex.