1

Nurses Communication with Transgender Patients

Alyssa Reiss

SCSBcN, University of Regina

CNUR 102-101 Foundations of Care 1: A Developing Professional

Professor Amanda Perkins

November 4 2020

Nurses Communication with Transgender Patients

Communication is a key element in the nursing profession. Communication can be

described as “The two-way process of exchanging, acting on, and assigning meaning to

messages” (Chute, A., 2020, Pg.710). The communication between nurses and transgender

patients is extremely important. Transgender people are those who identify as the opposite sex

they were assigned at birth. Many people who identify as transgender are often miss-

communicated with and it can cause a great amount of harm. Educating nurses on how to

properly asses and communicate with those faced with this day to day struggle, can help make a

difference in their lives and future care plans.

Educating Nurses

Educating health care providers, such as nurses, about the LGBTQ+ community is

important to helping assess transgender patients. Nurses often will come in communication with

people from this community and may find it difficult finding appropriate ways to asses them and

may find even more difficulty approaching those who identify as transgender. The term

transgender originated almost one hundred years ago and yet many transgender men and women

still are faced with intense health disparities and lack of access to health care (Frangella, J.,

Otero, C., & Luna, D., 2018). By looking further into what causes these difficulties there is

evidence that says it is due to nurses being uneducated and bias (Greene, M. Z., France, K.,

Kreider, E. F., Wolfe-Roubatis, E., Chen, K. D., Wu, A., & Yehia, B. R., 2018).

Case Study

In a recent case study, a 48-year-old transgender male named Andrew went to the

emergency room (ER) (Barredo, O., J., 2020). While he was there, he was faced with many

miscommunications. For example, the nurses addressed him by the improper name, he received
 3

an identification band with the wrong name, was asked if he has a penis, questioned about why

he wore a chest binder, and was given many dirty, confused and rude looks during his time spent

at the hospital. The lack of communication, education, privacy and respect between Andrew and

the staff in this hospital caused many issues that many transgender people may face today.

Becoming more educated about communication with these individuals will improve how

transgender patients feel towards seeking healthcare.

Creating a Therapeutic Nurse-Patient Relationship

Therapeutic nurse-patient relationships consist of awareness, openness, careful use of

language, having a non-judgmental attitude, and not treating LGBTQ+ patients differently

(Murdoch, N. L. H, & Crawford, J., 2020). In order to create this relationship nurses, need to

establish consent, respect the patient’s gender, sexual orientation and past history, and have a

private room to communicate. The use of proper terminology is a step in the right direction to

creating a therapeutic nurse-patient relationship.

The Use of Proper Terminology

In order for transgender people to access the health care they need; nurses need to feel

comfortable communicating with transgender individuals. An example is getting used to asking

the patients preferred name and pronouns (Faught, D.D., 2016). Individuals who are transgender

may consider themselves to be something other than male and female. By using the improper

terminology, patients may feel uncomfortable, unsafe, and confined to their own thoughts and

feelings which can lead to poor individual patient outcomes (Dorsen, C. 2012). A way nurses can

ensure they are using the proper terminology, is by the healthcare system creating forms or

electronic medical records that provide more gender options rather than only male and female
 4

(Strousma,2014, as cited in Faught, D.D., 2016). By doing so, nurses would be able to look at a

patient’s documentation and learn the preferred name and pronouns of their patient before

coming in communication with them. Addressing the patients by their preferred name and

pronouns as the first step in the assessment can be one easy way to make patients feel more

comfortable and open minded during their time spent with nurses leading to the most beneficial

care possible.

Consent, Respect and Privacy

Ensuring there is consent, respect and privacy can lead to well communicated discussions

that are important to patient’s health. Obtaining consent is when nurses make patients aware of

what they are doing before they do anything further. This can be as simple as asking the patient

if it is okay to listen to their heartbeat. With consent, it is also crucial to let patients know that

they are allowed to withdrawal at any given moment no matter what the reasoning may be.

Respecting transgender patients’ gender, sexual orientation, and past history will provide nurses

with a further understanding of their needs. When nurses are communicating with any patient it

is important to be in a place that is safe and private, but is especially important to those who are

transgender. It is most important to them because many thoughts, feelings and emotions will be

expressed and it is essential that whatever is said is kept confidential. Many of these patient’s

fear going to health care facilities because of previous discrimination and so it is important to

make sure they feel safe and respected in any environment they are in with nurses.

Conclusion

Nurses communicating with transgender patients has not always been ideal. Numerous

transgender men and women have faced discrimination and lack of health care access due to
 5

their identity. Nurses however, can improve these difficulties by becoming educated on the steps

of creating a therapeutic nurse-patient relationship. By the use of awareness, proper terminology,

consent, as well as respect and privacy, the care and communication towards these patients can

be enhanced.
 6

References

Barredo, J. O. (2020). Room Assignments, Gender Identity, and Gender Expression: A Case

Study on Caring for Transgender Patients. Medsurg Nursing, 29(4), 237-244.

https://search.proquest.com/openview/43d1ebf08c782c4bac24769766794e65/1?pq-

origsite=gscholar&cbl=30764

Chute, A. (2020). Communication: At the heart of nursing practice. In D. Gregory, C. Raymond-

Seniuk, L. Patrick, & T. Stephen (Eds.), Fundamentals: Perspectives on the art and

science of Canadian nursing (2nd ed.) 710. Wolters Kluwer.

Dorsen, C. (2012). An integrative review of nurse attitudes towards lesbian, gay, bisexual, and

transgender patients. CJNR (Canadian Journal of Nursing Research), 44(3), 18-43.

https://www.researchgate.net/profile/Caroline_Dorsen/publication/233533660_An_Integr

ative_review_of_nurse_attitudes_towards_lesbian_gay_bisexual_and_transgender_patien

ts/links/02e7e53c82c43d1a6c000000.pdf

Faught, D. D. (2016). Coming full circle: The old becomes new again--cultural competence and

the transgender client. Medsurg Nursing, 25(4), 285-287.

https://go.gale.com/ps/anonymous?id=GALE

%7CA461945708&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=10920811&p

=AONE&sw=w

Frangella, J., Otero, C., & Luna, D. (2018). Strategies for Effectively Documenting Sexual

Orientation and Gender Identity in Electronic Health Record. Studies in health

technology and informatics, 247, 66-70. https://europepmc.org/article/med/29677924

Greene, M. Z., France, K., Kreider, E. F., Wolfe-Roubatis, E., Chen, K. D., Wu, A., & Yehia, B.

R. (2018). Comparing medical, dental, and nursing students’ preparedness to address

lesbian, gay, bisexual, transgender, and queer health. PloS one, 13(9), e0204104.

https://doi.org/10.1371/journal.pone.0204104

Murdoch, N. L. H, & Crawford, J. (2020). Health, wellness, and illness. In D. Gregory, C.

Raymond, L. Patrick, & T. Stephen (Eds.), Fundamentals: Perspectives on the art and

science of Canadian nursing (2nd ed.) 149. Philadelphia, PA: Wolters Kluwer I

Lippincott Williams & Wilkins.