Potential emergency care problems of transgender people highlighted in case study

A prominent journal has published a new case study of one transgender patient’s horrific emergency room experience in the hopes that it will highlight some of the issues facing the community and help prevent these problems for other people who do not identify as their birth sex.

The study, which appears online in the Journal of Emergency Nursing, highlights the case of a transgender patient identified by the pseudonym of Brandon James, a masculine transgender man who transitioned with hormone replacement therapy five years before the ER visit in question.

James was asked to present his driver’s license, which identified him as a female, and had past medical records that also included female gender markers, study authors Ethan Collin Cicero, a registered nurse, and Dr. Beth Perry Black, both from Chapel Hill, North Carolina, explained.

During the check-in process, James said that staff gathered to discuss his gender aloud, even recruiting co-workers to chime in on the issue. James said he felt like “a spectacle” or “a freak show at the circus,” and that he felt the whole thing “was definitely to draw attention to the fact that my outward appearance didn’t match (my identification).”

How nurses can prevent this from happening

After a wait that lasted several hours, a nurse listened to James’ friend recount the experiences of the check in, apologized for the events that transpired, and validated their experience, officials at the Emergency Nurses Association said in a statement. ENA president Matthew F. Powers said that the story had “new implications for emergency nursing practice.”

“All patients must be treated with dignity and respect. We want nurses and their ED colleagues to understand how to give these patients the care and respect they deserve,” he said, adding that his agency “fully supports the best practices outlined in this article and supports further research around transgender emergency care.”

The ENA advised emergency room personnel to begin by asking the patient how they would like to be addressed, and then to use the pronoun that matches the gender that they currently identify with. Also, nurses should only ask questions that are clinically relevant, pertaining exclusively to the injury or illness for which the patient is currently seeking treatment.

The organization also noted that when the patient is taken to an area of the ER where they will be asked to share a space with another patient, the gender with which the patient identifies needs to be kept in mind. Finally, they emphasized that nurses need to lead by example, since they tend to be at the forefront of care and should be ready to deal with any sensitive situations that arise.

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Feature Image: Emergency Nurses Association