Emergency Care Considerations for the Transgender Patient: Complications of Gender-Affirming Treatments

Davis, Wesley D., Bhanuben Patel, and Jessica K. Thurmond. "Emergency Care Considerations for the Transgender Patient: Complications of Gender-Affirming Treatments." Journal of Emergency Nursing (2020).


Abstract

The transgender population presents a unique challenge for the emergency nurse. There are types of surgeries, medications, complications, and differences in laboratory testing that are unique to transgender people. In addition, emergency nurses are increasingly encountering more transgender patients in the emergency department for care, referrals, and education. Yet, many emergency nurses lack the formal training to care for transgender patients and their families. A complete understanding of the terminology, gender-transforming surgeries, hormonal suppression and augmentation of sexual characteristics, adverse effects, complications of surgeries, and ongoing health risks owing to the altered hormonal milieu and potential risk for acquiring sexually transmitted diseases is important to provide the necessary emergency care for this emerging population.

Keywords: Transgender persons; Gender identity; Sexually transmitted diseases; Emergency care

Implications for Emergency Nurses

Gender identity can heavily affect a patient’s overall health and the manner in which they seek emergency medical care. With the evolution and advancement of transgender medical care, emergency nurses are more likely to encounter transgender minority patients. Emergency nurses should know how to engage and communicate with transgender patients regarding their unique health care needs. Anatomical variations and hormone therapy are prevalent in the transgender population, and the emergency nurse must be prepared to manage their complications. Knowledge in these areas will improve effective and appropriate care for transgender patients.

Conclusion

Emergency nurses can help play a vital role in the care of transgender patients by learning about the health challenges they face and offering nonjudgmental care and education about their risk factors such as sexually transmitted diseases, specifically HIV. Understanding the effects of hormones and surgical complications, and applying the appropriate use of tests, nurses in the emergency department are the first-line health care workers who have the highest potential to have a favorable impact on the health of transgender people and make sure that they are getting the most advanced evidence-based medicine, comparable to their “cis” cohorts. Their knowledge and triage role can be the link to other health care professionals for ensuring that the complete physical and mental health issues of transgender patients are addressed, and appropriate follow-up care is arranged.

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