Here are five important lessons to help perioperative nurses gain the confidence to provide transgender-competent care:
Start with Conversation
If you are unsure about which name or pronoun(s) to use, just ask. Then make sure to consistently use their chosen name(s) and pronoun(s). With your patient’s consent, update this information in their chart so they aren’t forced to explain multiple times. Typically, a patient’s preferred name is listed in parentheses after their legal name in their electronic health record.
Be Clear About Why Their “Dead Name” Appears in Formal Medical Documentation
State and federal requirements call for two patient identifiers for things such as surgical procedures, treatments, and prescription dispensing. The identifiers usually include name and birthdate. However, for a transgender patient, they may consider their legal name as their “dead name” and wonder why they are seeing it on medical documentation. If this happens, explain: “state or federal laws require this action, but please know we will address you using your preferred name.” Once this process is explained to the patient, they tend to understand and will abide by the law or governance that guides this regulation.
Don’t Over-Ask About Previous Procedures and Medications
If it is not relevant to their presenting complaint, do not ask about gender surgeries, because “this can be dehumanizing and embarrassing.” Additionally, avoid invasive physical examinations if possible. “A vulnerable and visible gender-variant person might already feel like a ‘spectacle,’ and it is important to avoid further marginalizing them.”
During preoperative care, nurses can take these actions to help their transgender patient feel more at ease with their surgical care:
- Be open and honest about what tests need to be done and why
- Explain the procedure involved
- Address their concerns
- Outline the safety standards adhered to by your facility
Provide Appropriate Confidentiality and Ensure Privacy
Transgender patients are vulnerable to assault and harassment, making safety and confidentiality imperative. To safeguard your transgender patient:
- Find a private space for discussion
- Ask permission to disclose information to other providers
- Be mindful about what name someone is called in public spaces
Physical privacy is also important for transgender patients in surgical care. That’s why efforts should be made to reduce traffic and staff rotation in the operating room, especially if the surgical procedure involves exposure of genitalia or the chest area.
Create a Welcoming Environment
Displaying outward signs of acceptance signals to your patients they are in a safe space, which can significantly impact their experience. These can include:
- Signage
- Rainbow stickers
- Pronoun pins
Together, let's champion diversity, equity, and inclusion, ensuring that every individual-periop nurses and patients-feels valued, respected, and empowered in the pursuit of optimal health outcomes.
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