For this virtual reality assignment, “Eden Lab-Trans Health & LGBT Aging”, I had the wonderful opportunity to witness the life of a 72-year-old transgender woman as well as the LGBAT perspectives of Eden’s new community. It was an insightful experience that allowed me to ponder the idea of about the brain-body connections that determine an individual’s gender identity. Prior to this video, my understanding of gender identity was that it was primarily influenced by personal experiences gained through socialization. However, this virtual reality enhanced my understanding of gender identity by reflecting on a combination of influences, nature versus nurture. In the video, the narrator expressed that “gender identity, the internal sense of being male or female, is also biological and based on factors in the brain”. The narrator further expresses that after the first trimester of pregnancy, the external anatomy that determines our sex is formed, however, the brain continues to grow throughout the last two trimesters of pregnancy which can result in variations of gender identity. A person who identifies as a transgender person is when their external anatomy depicts one gender, while their brain anatomy depicts another. Thus, even at young ages people may identify with a gender opposite of their external anatomy, and it is our role in society to respect, support, and honor their identity preferences.

As LGBT individuals are becoming increasingly more understood and favorably recognized in our society, it is a nurse’s role to honor and dignify them including elderly identity preferences by providing culturally competent care and communication. There is an elderly LGBT population that deserves as much empathy and understanding as do their younger counterparts and there are numerous ways a nurse can provide the best possible patient care while at the same time honoring elderly patients’ identity preferences. Nurses need to be aware of the gender in which an elderly patient identifies and not make assumptions based on biological anatomy alone.  A nurse should practice active listening and ask the patient about their preferences, which consequently can allow the nurse and the LGBT client to establish trust and a good rapport. For a nurse to provide the most competent care, they need to be non-judgmental because being unbiased is critical in order for the client to receive the best quality of care.

Like all elders, transgender individuals should be provided equal, proficient optimum healthcare.  We must not assume anything, and we need to obtain as much information as possible to ensure transgender patients receive the necessary care as would be provided any patient.  For example, as a nurse, we would never assume that an elder patient has deficits in hearing, vision, or mobility. Instead, we ask the patient a series of questions to determine if they experience difficulty with daily tasks, or have hearing, vision, health, and/or mobility issues. If a patient indicates physical deficits, we nurses would implement interventions that will assist them in those areas as well as to increase their comfort and overall well-being. The same would apply to all patients including transgender elder individuals as well.

In addition, many transgender individual’s undergo hormone therapy and gender affirming surgery, and therefore, as nurses we must be mindful and educated on these procedures in order to be sensitive to the patient’s needs and to provide high quality care.  Hormone therapy is when people take hormones that will produce physical anatomical changes, while gender affirmation surgery refers to surgical procedures to change a person’s physical characteristics according to their identified gender. Overall, one way that nurses can provide competent care is to be educated on the LGBT community and know what the current medical practices are for transgender patients that may need to be attended to while receiving other medical treatment.  Awareness is the key to good nursing, and it applies to all people including transgender people as well. 

Furthermore, if I were to ever identify discriminatory behavior related to an individual’s identity/sexual orientation or for any other reason for that matter, I would intervene and advocate for the best patient because it is my job as nurse to provide optimum care to all patients regardless of their choices or beliefs.  In order to insure we do not practice any discriminatory behavior, as nurses, we must reflect within ourselves, and regardless of what our beliefs are, we must be open-minded and sensitive to the differences of others.  It is our job to be compassionate, kind and to provide a gentle hand to all patients equally, and it is our job to intervene if ever I witness discrimination. It is critical the discrimination of any kind be stopped because personal and societal biases can have adverse consequences in the outcome of a patient’s care.  Transgender individuals should not be treated any differently than any other patient, and I will work to ensure that my transgender and transgender elderly patients are treated equally and fairly because they deserve the best care possible.