Clinical Care of the Transgender Patient
Course #71923 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
This course encompasses a basic overview of individuals experiencing gender dysphoria. It begins with an understanding of the spectrum of gender identity variations and gives best estimates of the prevalence of transgender individuals in the population. Discussion will focus on barriers to care, the unique healthcare needs of these individuals, and approved standards of care. Specific discussion will focus on endocrine management of transgender individuals, non-surgical interventions such as voice therapy and counseling, and surgical interventions for both male-to-female and female-to-male transsexuals. Discussion will also include the emerging science of caring for transgender children and adolescents.
- INTRODUCTION
- DEFINITIONS
- HISTORICAL PERSPECTIVE
- ETIOLOGY OF GENDER DYSPHORIA
- PREVALENCE OF TRANSGENDERISM
- UNIQUE HEALTHCARE ISSUES
- ACCESS AND BARRIERS TO CARE
- STANDARDS OF CARE
- PSYCHOLOGICAL MANAGEMENT
- HORMONAL AND NONSURGICAL MANAGEMENT
- SURGICAL INTERVENTIONS
- LIFELONG PREVENTIVE AND PRIMARY CARE
- MANAGEMENT OF TRANSGENDER CHILDREN AND ADOLESCENTS
- EDUCATION OF HEALTHCARE PROFESSIONALS
- CONCLUSION
- RESOURCES
- Works Cited
- Evidence-Based Practice Recommendations Citations
This course is designed for all members of the interdisciplinary healthcare team, including physicians, physician assistants, and nurses, involved in the care of transgender patients.
The purpose of this course is to provide members of the interdisciplinary healthcare team with the knowledge and resources necessary to improve the care provided to transgender patients, a population historically underserved.
Upon completion of this course, you should be able to:
- Define terms used to describe the spectrum of gender expression.
- Review the historical perspective of the treatment of gender dysphoria.
- Assess current theories and quality of evidence that pertains to the etiology of gender dysphoria.
- Discuss efforts to determine the prevalence of transgender individuals in the population.
- Describe the unique healthcare needs of the transgender population.
- Summarize the unique barriers to care in this population.
- Facilitate the management of psychological issues experienced by transgender individuals.
- Discuss the potential benefits, limitations, and risks of hormonal and nonsurgical procedures and associated care involved in the treatment of transgender individuals.
- Describe the care transgender patients require in undergoing various surgical procedures.
- Develop a strategy of collaborative practice that addresses lifelong healthcare needs unique to transgender patients.
- Discuss the unique needs of transgender children and adolescents.
- Summarize the state of the education of healthcare professionals in the care of transgender patients.
Sandra Mesics, CNM, MSN, RN, is a native of Bethlehem, Pennsylvania. She attended Penn State University where she graduated with a BS in Psychology. In 1983, she moved to Miami, Florida, where she earned a BS degree in Nursing at Barry University, graduating magna cum laude. Ms. Mesics worked as an RN in Labor & Delivery, postpartum, and newborn nursery at Mount Sinai Medical Center, Miami Beach, FL, and started work on her Master's degree in 1994. She became a certified nurse-midwife in 1997, and was the first nurse-midwife granted privileges at Mount Sinai Hospital of Greater Miami. In 2001, Ms. Mesics returned to Bethlehem, PA, to accept a faculty position teaching maternity nursing at St. Luke's School of Nursing. She also maintains privileges at St. Luke's Hospital, providing nurse-midwifery care in the women's health clinic. In 2004, Ms. Mesics became director of the School of Nursing. She is a member of Sigma Theta Tau Nursing Honor Society, the American College of Nurse-Midwives, and the National League for Nursing. She served on the advisory committee for fetal fibronectin.
Contributing faculty, Sandra Mesics, CNM, MSN, RN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Alice Yick Flanagan, PhD, MSW
Margaret Donohue, PhD
The division planners have disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.