Dawn Mangine

    It’s estimated that the transgender population in the United States is very small, with census numbers ranging from 0.6 percent to 1.2 percent of the adult population. However, this small population is disproportionally affected by mental health issues and homelessness.

    Among the statistics: As compared to the general population transgender people are:

    • Three times more likely to attempt suicide
    • Twice as likely to be homeless
    • Six to eight times as likely to suffer from depression
    • Twice as likely to be assaulted or victimized in some way

    Unfortunately, transgender people who seek healthcare frequently face discrimination due to lack of knowledge and bias on the part of providers. The National Center for Transgender Equality found about a quarter of survey respondents decided not to seek medical care due to fear of being mistreated. Failure to provide appropriate care and violent behaviors directed at this population lead them to avoid preventative health care, as well as care for illness or injury.

    The good news is that healthcare educators are beginning to address this discrimination by creating simulation scenarios incorporating care for transgender patients. These simulations range from nursing students working with high-fidelity manikins to interprofessional education (IEP) in a hospital setting with standardized patients (SPs).

    Remote Learning Resources

    Even more encouraging, these types of educational scenarios will not only serve to decrease discrimination, but will improve healthcare outcomes for patients who identify as transgender, gender non-conforming, and other queer patients.

    Although younger healthcare providers are more trans-accepting, they still are struggling with being trans-educated. Simulation provides the pathway toward helping students and healthcare providers learn the unique challenges faced by transgender patients.

    Simulation Learning Objectives

    • Describe the barriers related to and faced by transgender and gender non-conforming patients in the context of receiving care in healthcare settings: pre-hospital, emergency departments, community health clinics, primary care offices.
    • Identify the various roles of a nurse in the context of providing care to a transgender patient in those settings.
    • Evaluate the effectiveness of the nurse or other healthcare professional in carrying out those roles through the patient interaction.
    • Identify tools to develop into nursing care to develop a practice that is informed, sensitive, affirming, and empowering.

    The scenario objectives seek to enhance communication with the patient. Within the context of IEP scenarios, demonstrate effective communication that is also affirming throughout the collaboration (Identify, Situation, Background, Assessment, Recommendation, Read back). These types of scenarios will help healthcare professionals recognize and demonstrate behaviors that create a safe, welcoming, and professional environment.


    Simulation ideas for transgender patients:

    "Simulation: A Path to Better Care for Transgender Patients"

    Promoting Affirmative Transgender Health Care Practice within Hospitals