Transgender People and Osteoporosis (Nursing)

00:01 Hi, welcome to our video series on Geriatric Nursing.

00:04 Now in this portion of the video series, we're going to talk about the health care of transgender people in particular osteoporosis.

00:13 Now, I selected this quote for us to start the presentation with.

00:18 So let me read it to you.

00:20 "Every person who seeks health care should be affirmed, respected, understood, and not judged." And that's the whole reason for doing this portion of the series.

00:31 Now, I understand that this topic can be a hot topic, right? It causes a lot of discussion.

00:37 I'm not here to debate the topic.

00:39 What I am here is to help you understand how do we provide health care, how do we help all people, every person who comes to us that wants to have health care that they feel affirmed, that they are respected, that they feel like we're trying to understand, and we're not judging.

00:59 Okay, so that's the perspective we're coming from.

01:02 So first, we're going to need to start out with some definitions just to make sure we're all coming from the same starting point.

01:09 So for this discussion, this is how we're going to define two key words, sex and gender.

01:17 Okay, so first, let's take a look at a dictionary definition of sex.

01:22 Now, sex would be considered assigned at birth, and it refers to one's biological status.

01:28 Gender, on the other hand, is looked at as more of a social construct.

01:32 So the definition goes like this.

01:35 Gender is socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate.

01:44 So for the purpose of this discussion, talking about the health care of transgender people, I want you to when we refer to the terms sex, and gender, these are the definitions that we're using.

01:57 Now, cisgender is a term that you also hear in many of these discussions.

02:02 Cisgender means the identification with a gender that is congruent with the sex assigned at birth.

02:09 That means I consider myself a cisgender female.

02:14 I identify as a female and that was also the sex I was identified at birth.

02:20 Transgender is different than cisgender in this perspective, transgender means the identification with a gender that differs from the sex assigned at birth.

02:32 Now, this includes the many ways that people's gender identities can differ from the sex they were assigned at birth.

02:38 So you can be a trans woman, a trans man, you might consider yourself non-binary.

02:45 All of those things can be included in transgender.

02:49 Hey, we want to make this point.

02:51 Conversation is the key.

02:53 Because there is a lot of subjectivity in this movement and in understanding.

02:58 So it's important that you find out what is important to your particular client in a way that matters to the healthcare you're discussing.

03:07 Now, gender dysphoria.

03:08 This is a term it was a concept that was designated in the DSM-5.

03:13 Okay, so the DSM-5 is a manual for mental health.

03:17 And gender dysphoria is a clinically significant distress or impairment related to a strong desire to be of another gender which may include the desire to change primary and or secondary sex characteristics.

03:30 Not all transgender or gender diverse people experience dysphoria.

03:36 So what does all this mean to us as nurses? Well, these are key terms.

03:41 If you're going to help change healthcare so that all people receive the kind of health care that's needed and communicates respect, you need to familiarize yourself with these terms.

03:53 So sex and gender and transgender and cisgender and gender dysphoria are five key terms I want to make sure you have a clear definition of.

04:04 Now when you're in discussions with people about this, make sure you're both coming from the same definition of these terms.

04:11 So remember, this was originally in the DSM-5.

04:13 It's a mental health manual that we designate diagnoses in.

04:19 But the last point is something that I want you to understand is that not all transgender or gender diverse people will consider themselves with gender dysphoria.

04:30 Gender affirming care.

04:33 Now this can get very specific.

04:35 Here is the definition we're going to use from Radix, Reisner and Deutch.

04:40 Health care that holistically attends to transgender people's physical, mental, and social health needs and well being while respectfully affirming their gender identity.

04:52 So what this means is, it's aside from your personal worldview, what we're talking about is how do you do provide care to a client that addresses their physical, mental, social health needs and their well being and delivers it with respect according to their affirmed gender identity.

05:16 Clients who identify as transgender may choose to receive hormonal treatment.

05:22 Now the reason they make this decision for hormonal treatment is their desire to change their physical characteristics to the characteristics of their gender identity.

05:33 So let's walk through how this works.