Lisa Smith
Sexuality begins in adolescence with physiological inundations of hormones and rapid growth.
A study conducted on the social impacts of sexual development concluded homosexuality as a
minority and identification multifactoral (Mustanski, et al., 2014). Frequently in the homosexual
population, a preventative approach is used with sexually transmitted infections. A prophylactic
approach has social and moral injustices within some cultures (Fiereck, 2015). From a nutritional
standpoint, eating disorders are frequent in the homosexual population with under nutrient
associated with gay males, and a more considerable physical stature identified with lesbian
females (Kolodziej, Urtnowska-Joppek, & Suwala, 2018). Cancers common among the gay,
lesbian, bisexual, transgender population include lung, endometrial, prostate, colorectal, cervical,
anal, and breast cancers while oncologists reported lack of population-related health needs
(Tamargo, Quinn, Sanchez, & Schabath, 2017). The Diagnostic and Statistical Manual (DSM)
maintained homosexuality as a disorder until 1973, and assumptive sexuality positions are often
encountered (Manzer, O’Sullivan, & Doucet, 2018).
References
Fiereck, K. (2015). Cultural conundrums: The ethics of epidemiology and the problems of
population in implementing pre-exposure prophylaxis. Developing
World Bioethics, 15(1), 27–39. doi:10.1111/dewb.12034
Kołodziej, K., Urtnowska-Joppek, K., & Suwała K. (2018). The perception of your body by
homosexual people: Eating disorders. Journal of Education, Health and Sport, 8(9), 103-112. doi:
10.5281/zenodo.1344921
Manzer, D., O’Sullivan, L. F., & Doucet, S. (2018). Myths, misunderstandings, and missing
information: Experiences of nurse practitioners providing primary care to lesbian, gay, bisexual,
and transgender patients. Canadian Journal of Human Sexuality, 27(2), 157–170. doi:10.3138/
cjhs.2018-0017
Mustanski, B., Birkett, M., Greene, G. J., Rosario, M., Bostwick, W., & Everett, B. G. (2014).
The association between sexual orientation identity and behavior across race/ethnicity, sex, and
age in a probability sample of High School students. American Journal of Public Health, 104(2),
237–244. doi: 10.2015/AJPH.2013.301451
Tamargo, C. L., Quinn, G. P., Sanchez, J. A., & Schabath, M. B. (2017). Cancer and the LGBTQ
population: Quantitative and qualitative results from an Oncology Providers’ survey on
knowledge, attitudes, and practice Behaviors. Journal of Clinical Medicine, 6(10), 93. doi:
10.3390/jcm6100093less
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Lawrence Brodhead
Health Concerns
A study that gathered data between the years of 2014 through 2016
found that transgender groups of people experience worse mental health and
disabilities, had an increased likelihood of having multiple chronic conditions, and
a poor quality of life, in comparison with a non-transgender group of people (Downing
& Przedworski, 2018). Because transgender populations face a lot of stress related to
discrimination, harassment, and rejection, suffering emotionally and psychologically is
eminent in my opinion.
Pregnancy and STIs
When you think about transgender and pregnancy, it does not seem possible. I have
seen some postings on social media sites of transgender couples that are
having children. There are photos of men with a pregnant belly, and I must say it looks
odd. The pregnant male is transgender and was born with a female body. She quit
taking testosterone, which was helping her to transition, and was able to become
pregnant. Providing proper pre and post-natal care for transgender individuals is
needed, but with regard to the individual physical and emotional needs that the patient
may require based on their sexuality.
“Transgender women are internationally recognized as a population group that carries
a higher burden of HIV infection, with a worldwide HIV prevalence of 20%” (Safer et al.,
2016). It is important for providers to assess for STI’s with their transgender
patients based on their current anatomy and sexual behavior and screen for STI’s, as
they would any other patient (Safer et al., 2016).
Psychosocial Needs
The transgender patient may encounter many different psychosocial needs. Exploring
their sexuality, accepting their preference and coming out may be difficult for them.
Lack of support and discrimination can provide mental health issues. As a provider, I
would be aware of and assess for mood, anxiety, stress, and substance abuse and
choose appropriate interventions.
Care
As mentioned above, caring for a transgender patient would include being aware of
and anticipating specific issues such as mental health. I also think it would be helpful
to educate myself on this population so that I can more readily anticipate their needs.
“Transgender patients report that lack of providers with expertise in transgender
medicine represents the single largest component inhibiting access to care” (Safer et
al., 2016). Since transgender treatment is not taught in most curriculums, I would
advocate for more research and education for caring for this population.
Have any of you encountered a transgender patient and if so, what were your
challenges? Is it less of an ethical dilemma in larger cities?
References
Safer, J., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J.
(2016, April 1). Barriers to Health Care for Transgender Individuals. doi:
10.1097/MED.0000000000000227
Downing, J., & Przedworski, J. (2018, July 18). Health of Transgender Adults in the
U.S.,
2014-2016. Retrieved from DOI: 10.1016/j.amepre.2018.04.045
