Care to the Trans* and Gender Non-Conforming Identified Patient

This video is one in a series created for nursing and healthcare educators for use in a variety of settings. Complete information about this scenario, from set-up to debriefing questions, can be found at cms.montgomerycollege.edu/nursingsims/
Montgomery College's nursing program currently enrolls 400 students annually at the Takoma Park/Silver Spring Campus. Students who successfully complete the nursing curriculum earn an associate of science degree (A.S.) in nursing and are qualified to take the examination to be licensed as a registered nurse. The nursing program also participates in the Maryland Articulation Model, which allows students to transfer to a four-year state college or university to complete a bachelor's degree in nursing. For more information about Montgomery College's nursing program, visit: cms.montgomerycollege.edu/nursing/

[@TheDonna1959]

Showing people respect goes a long way no matter where they come from...🌹

[@miserable.morality1663]

This is honestly a horror movie to me. I can’t even imagine being in this situation, doctors appointments with dysphoria are shitty.

[@amberharmsen2497]

ikr

[@ThienTruong-iy5ix]

maybe I live in a more liberal state but it shouldn't be this cringe in the doctor's office.

[@Spider_lily021]

If you call ahead of time to notify the office they can make those changes or put a flag on your chart so they know what you want to be identified as, but they’ll probably still ask for you to confirm their identity. That’s what I’ve seen at most California doctor offices for trans patients.

[@bugga179]

I feel like this is def a situation that takes both parties. The patient needs to understand that at a first visit explanations will be necessary as they form a relationship with their provider. With how paperwork it currently they do need to pick their biological sex so they can get the best care possible. Due to sex specific diseases and treatments/exams. A provider needs to make notes for future visits and immediately respect all their wishes using what they asked and learned. Making sure they are as comfortable as possible to get the best care.

[@TheSnyderWeb]

I'm not a nurse or anything medical but I found this really interesting. Thanks for making it!

[@kentokyo]

They all sound so intelligent, attentive and professional!!!

[@nicolecruz869]

i honestly loved the way that the nurse handled the situation. shes absolutely amazing.

[@JimmiAlli]

The nurse seemed really lovely.

[@joanneiverson4754]

Well simulated. As a nursing professor, I have not know how to address these issues and your videos will provide a means to open up the topic of trans and gender non-conforming identified patients that we are seeing in our practice. Thank you for helping train us to be more compassionate in our pratice.

[@lalva14]

OMG thank you thank you! As a confused and uncomfortable high school teacher I found this video to be really helpful. We all want to be sensitive and compassionate but often do not know how. Thank you for teaching me how to be more communicative and aware. Sorry, I was not brought up this way and it’s very hard to find my way in the dark. I will share this with my colleagues and students. Again, thanks.

[@hildawilson5135]

Respect should be shown to everyone! Call the patient Joe. We do have to be realistic some exams are confined to gender i.e. male and female . A MTF will not have a paps smear and FTM will not have a prostate exam. Finally dosing and certain ailments can be gender specific. These are issues that have to be viewed realistically and true assessments are needed which goes beyond pronoun usage. Respect goes both ways and everyone deserves standard care. Nevertheless besides platitudes keep in mind that medical licenses are on the line .

[@nylonsghost7938]

Personalized 👏 healthcare instead of 👏 blanket care 👏 Like some cis women don't even have uterus' so why would their forms have that shit >:v

[@nylonsghost7938]

@David Vanpatten then what about the roughly 2.5 million people who are trans or intersex? That's a lot of peole man Normal is entirely subjective and you ignored what I said abut some CIS women being BORN without full uteris' Or the CIS MEN who grow breasts? They arent too common I guess but there's enough cases that we know how to effectively treat them Treating sex like its binary harms everyone. Very few things in biology are absolutes

[@unclenelvis]

Prostrate?

[@hildawilson5135]

unclenelvis prostate -typo!

[@aaronjames3228]

@@nylonsghost7938 ?

[@NikkieRoxxx]

Just ask the person: they know how they want to be adressed! And dont be affraid to apologize, everyone makes mistakes!

[@pakoupope9195]

Ok, so the doctor's hair is AHMAZING!!I love that look!

[@knzay]

of course the black woman comes in and fix everything #blackgirlmagic

[@joshuadespain5048]

Really?

[@jacquelinelowery5589]

Do we really have to bring race into this already complicated issue?

[@jacquelinelowery5589]

@MsAgnostica Goes Quantum I understand your point, but you have to know that these are just actors playing a role given to them. That could've easily been a person of another race doing that part and showing empathy. Yes, I agree that some Black women know what discrimination feels like but are they all so accepting and empathetic to this lifestyle?

[@gotodgen1diabloimmortalnew236]

Your problem isn't racism or white people. The problem is your culture.

[@georgannenelson105]

Why didn't he just say he's trans.

[@miserable.morality1663]

Dr Mobius II okay, transphobe

[@dragonslayer101]

Probably to prevent transphobia, also because he wants to be stealth.

[@Basstroutfishing]

It's relatable for a lot of different situations, some people are just not comfortable and may appear rude, or hostile for no just reason or the nurse may have their own issues with difficult patients or pressures from dr's and nurse's to get the certain vitals, etc. They aren't trying to be petty but this seems like an oddly nuanced, polite scenario. I'm not sure why the nurse is so emotionally fragile, is he in love with this male patient it's hard to tell

[@oliviafranklin4627]

This is a really good material!

[@sreedeviraju877]

really interesting,i would like to use it,how can I ?

[@nondescriptnyc]

I am saying this as somebody that fully supports the trans/non-binary community: The “lessons” in this anecdote are unrealistic and offensive. Medical offices these days DO grill everyone about their current insurance coverage, addresses, ID, etc. (to ensure proper billing and, more importantly, to avoid mistaken patient identities), and it is unrealistic/irresponsible to expect the medical professionals to make assumptions about everything, just by repeating “I am Joe” and “call me Joe,” trans/non-binary or otherwise. If you prefer a female provider, that’s on you as a patient to indicate so-trans/non-binary or otherwise-and you should not expect others to make that judgment for you because that is your personal choice/preference. In fact, some trans/non-binary individuals DO prefer male providers, which takes us to the point about this lesson being offensive. It is offensive to me because, according to this anecdote, we are to make a wide range of stereotypic assumptions and generalizations about the trans/non-binary community, as though gender dysphoria is one simple category (e.g., trans/non-binary patients all prefer female providers and we should all know that).

[@daoistdansah54]

...but he said he was surprised by staff behavior based on how progressive the forms were and then she proceeded to apologize....and yes

[@sharontabb4576]

Great Job, sensitivity training.

[@alexthejustok]

As a trans guy this is like watching a real life horror show. I had to pause the video a few times because it was so uncomfortable, but also so real and similar to my own experiences. The staff wasn't overtly cruel or transphobic. Most aren't. They genuinely didn't know any better, but it doesn't make the experience any less humiliating or emasculating. I drive over an hour to my doctor's office and pharmacy in the city once a month to avoid this kind of thing and I'm honestly lucky to be so close to trans inclusive care

[@krae7156]

Thank you so much for sharing your experience which helps to validate the legitimacy of this simulation. There are so many things to discuss here-particularly as it relates to care. Like others have said its not overly transphobic but there are micro aggressions. So many questions: in what ways could the front staff have demonstrated a more inclusive environment? Certainly more staff training was warranted-particularly When the client/patient shared that the pre visit forms were progressive. But its nit about forms. Also, its quite interesting that The only thing the client/patient wanted or needed was a flu shot yet his identity became this big issue. This is certainly relevant for care but was it necessary in the context of a flu shot? Notice Joe never took his coat off. Was that an extra consideration of psychological protection in A situation that was already stressful? So many questions with this video to make for a great discussion. Including what professional values did the nurse exhibit?

[@SirSploogy]

I had basically the exact same experience at the dentist a few weeks ago. On the paperwork they had for new patients there was a gender section. They seemed to not know that section was there and continued to misgender me the entire time. I pointed the section out and they were very confused. Needless to say I have a new dentist.

[@yakkyjoe1]

You are offended when a stranger calls you by your legal name. You are offended when staff want to examine you. Busy professionals need to change the protocols that every other person complies with. How about you suck it up and act like adults.

[@jks9204]

T Kendall Exactly

[@threewagthepenguin9869]

@AceOfHearts I mean yeah everyone deserves to be treated equally and right but you're making it sound like what they were doing is inhumane and is complete savagery towards innocent victims. When all I saw was yeah it must have been awkward for the person but I also saw that it was awkward for the old lady and the other guy, they probably have busy schedules and have other stuff in their heads.

[@threewagthepenguin9869]

@AceOfHearts I never explained anything though I just said that there are more sides to a story, I try to see all sides of a situation and even though it is hella uncomfortable for him it also must have been uncomfortable for the staff too (well at least in a real setting). I also don't consider myself part of the LGBT+ community because even if I agree with them it's not a 100% thing ya know I like to consider myself someone who just happens to be bisexual. I really am sorry if you got offended but I believe that not taking ideas from people different than you is not the way to go. Ideally someone who never had anxiety will most likely not understand how it feels but it doesn't mean they can't try and help a person just because they don't have any ground on that subject, they can have sympathy but not empathy (going on that sympathy would be caring and understanding towards the person instead of being able to experience their feelings).

[@threewagthepenguin9869]

@AceOfHearts also yeah I don't know what your experiences were those people could have been disrespectful and not being professional but from what I saw of this video is that there were misunderstandings and they weren't being disrespectful or intolerant towards him, even the nurse was apologizing and I could feel how awkward it felt for both of them because it was basically said out loud to everyone in that room and he probably doesn't want the whole room to know lol.

[@threewagthepenguin9869]

@AceOfHearts I didn't mean it like that, I said that they mentioned his old name out loud, something that is not part of him anymore, it isn't his identity. When he was being called the first time you could see the discomfort and he was looking around, it looked like discomfort to me, so you can't tell me that's a lie, there's nothing wrong with that. Secondly, like I said the first time I understand they didn't use his pronouns and addressed him correctly but they weren't doing it deliberately. Nowhere were they shown hostile, sure the old lady looked a little confused at first but she tried to respectfully inform him about the issue and tried to help him out afterwards. The same thing goes for the nurse as he tried to fix the issue, and they were probably not informed as he still didn't change his name legally on his license. These are individuals who have their own lives, try to understand their side and don't cling to one side, to me you're the one that seems to not have empathy or understanding.

[@oliverwain5200]

That would have been the most humiliating and pressured situation as a trans man. Joe in the video handled pressure to give consent to a procedure he was clearly uncomfortable with well- but in that situation, some would either break down or leave and not get the help they need. Training is known to be effective in creating a more inclusive and understanding environment :)

[@dailealexander2055]

In this day & age, sensitivity training should be MANDATORY throughout medical offices in the United States in regard to treating transgender, genderfluid, agender & nonbinary folks -- no one should EVER have to go through such a humiliating & emotionally distressing ordeal just to receive proper medical care. Do you have any idea how cruel & distressing it can be to deadname a transgender person (i.e. call them by their "birth name," not the name they've chosen since they've transitioned) or repeatedly refer to them by the wrong pronouns? Seeing this type of shit makes me so mad... it's dehumanizing treatment like this that puts most trans & nonbinary people off from going to the doctor regularly or receiving the medical or dental care they need. A little compassion & understanding can go a LONG way. ❤

[@dailealexander2055]

@Snutih Uh... in case this isn't already clear to you (and obviously it isn't), "birth name" and "legal name" are two very different things. Your birth name is the name you're given by your parents at birth. Most trans people legally change their name from their birth name to a different name that is more befitting once they start to transition. LEGALLY. They fill out all the paperwork required to have their name LEGALLY CHANGED on all of their official paperwork, their driver's license, their passport, their birth certificate, social security info, etc., etc. Deadnaming is indeed a very real thing, my dude. If you call a trans or nonbinary individual by their birth name instead of their new post-transition name, this is considered rude, ignorant, insensitive and can be extremely mentally distressing for the person being deadnamed. Basically -- just call people what they want to be called. It's honestly not that difficult. Have a little kindness in your heart, not hate.

[@dailealexander2055]

@Snutih BIRTH NAME AND LEGAL NAME ARE NOT NECESSARILY THE SAME THING. Did you honestly not realize that it's possible to legally change your name from your birth name to a different one? People -- both trans people AND cisgender people -- legally change their first names ALL THE TIME, for a wide variety of different personal reasons. So someone's "birth name" may not be their legal name now. Honestly, I don't see why this is such a hard concept to grasp. It's not exactly rocket science we're talking about here. And yes, friend, nonbinary people DO EXIST. They have always existed. ALWAYS. There is absolutely nothing new about them. Nonbinary people aren't confused about their sexuality or gender identity, nor are they following some new fad -- nonbinary identities have been recognized for millennia by different cultures and societies throughout the world. There are so many different cultures that have always recognized that nonbinary people exist -- look up the hijras of India, the fa'afafine of Polynesia, the Mahu of Hawaii and Tahiti, the sipiniq of the Inuit, the two-spirit people of many Native American cultures, etc., etc. I could keep listing examples all day. Simply look up "Third gender" on Wikipedia and you'll find an entire wealth of knowledge about nonbinary people and how they've been recognized in different cultures throughout human history. Nonbinary people not only exist, but they've always existed, and they will continue to exist for as long as human beings survive on this planet. Just do some research. Don't be ignorant. Educate yourself.

[@jesseberry2046]

I wish drs and nurses would understand my Dr kept telling me she needed an exact date of my last menses I'm trans ftm I dissociate when I get that

[@aaronjames3228]

Well you still have a female system so it's important to know. It's no big deal. Just a question they need to know

[@jesseberry2046]

@@aaronjames3228 i dissociate when I get it so I don't know or remember I tend to lose the dates and hours that I have it

[@jesseberry2046]

@@aaronjames3228 also who knows exactly what date and or time that shit starts sometimes I wake up and it's there others times i have blood at a random time and pass out when I see it so idfk exact times and dates

[@snowwhiterosered8571]

@@jesseberry2046 most people know the general time, if not the exact date. It was important for my doctors to know when I got mine so they could figure out my due date when I got pregnant. Thankfully I texted my husband about it so I was able to find the exact date

[@jesseberry2046]

@@snowwhiterosered8571 but I'm transgender asking a trans man who dissociates when they bleed bc it's not normal and passes out from the sight of blood is not really fair plus being trans i don't get that scary shit every month

[@andrewharlacher3414]

Weird

[@user-em4rk4qo1f]

lmao as a trans person this is hilarious. Good video though !!

[@pauloq3814]

yes we have to pass all this

[@JK_JK_JK]

Gynecology (n.) also gynaecology, "science of women's health and of the diseases peculiar to women," 1847, from French gynécologie, from Latinized form of Greek gynaiko-, combining form of gynē "woman, female," from PIE root *gwen- "woman." Second element is from French -logie "study of," from Greek (see -logy).

[@Ranzo24]

I don't think this is a good reference for gender non-conforming individuals, but for TRANS people and the treatment thereof. This is obviously an FtM transexual who has not done his paperwork prior to his doctors' appointment...Thus the reason he said, "Please call me MR. Ramirez. " Gender non-conforming individuals or non-binary people don't fit either box or both, which is why it's so hard. As a Non-Binary individual, we prefer GENDER NEUTRAL pronouns not bound to cisgendered normalities.

[@kirstendessner-sweeney5823]

my heart is racing even in this video because ive experienced this so many times

[@reflectionsinthebible3579]

give me a break. seems the problem is not the staff, it is the system they have on the computer and the patient jo who was completely non compliant. and all they need is a spot for extra notes about patient not making all forms trans.

[@aidenberzins]

There is more of a problem in just the systems. The video also shows the staff repeatedly misnaming the patient who then no longer feels comfortable. You do need consent in order to treat a patient so him being "non-compliant" is a farce. He has the right to proper and affirming care. The MD who later comes in and discussed what she is trying to do shows why we need more training for all staff and not just doctors.

[@dailealexander2055]

NON-COMPLIANT?!! I'm sorry, but what video were YOU watching? How on earth was he being "non-compliant," exactly? By patiently & politely correcting the staff every single time someone called him by the wrong name or repeatedly referred to him by the wrong pronouns? If you ask me, this young man conducted himself admirably. He never once lost his temper or went off on the staff (even after they kept referring to him as JOSEPHINE numerous times after he calmly told them, "No, it's actually Joe") -- let me ask you something, how would YOU feel if you ever went to a doctor's appointment & the staff insisted on calling YOU by the wrong name & the wrong pronouns, even after you repeatedly corrected them? You're telling me you'd be totally fine with that? You'd just stop correcting them & let them refer to you by any name or gender they wanted? Yeah... somehow, I doubt it. You'd probably be outraged. And rightly so. I know I would be. It's 2021, not 1950 -- there's genuinely NO EXCUSE for medical offices to be this insensitive to trans or nonbinary people anymore. It's because of humiliating & dehumanizing treatment like this that most transgender people avoid the doctor entirely instead of getting the medical care they desire/require.

[@michellbradley4025]

Smh

[@georgetatsak2194]

It is hard to believe this person will ever have a meaningful or productive life 😪

[@dailealexander2055]

Um... what on earth would EVER make you say something like that? Do you not realize how many transgender, genderfluid & nonbinary people are out there in the world, with partners & children & fulfilling careers, living perfectly happy & productive lives? You need to seriously educate yourself on the trans community. Transgender & nonbinary individuals may face more challenges in their day-to-day lives than cisgender people do (as evidenced by this video), sure, but that definitely DOES NOT mean they're all destined to live sad or meaningless, unproductive lives. There are thousands of transgender & nonbinary doctors, lawyers, nurses, teachers, police, college professors, scholars, filmmakers, writers, artists, pharmacists, medical professionals, office administrators, guidance counselors, etc., etc. all living totally happy, normal lives.

[@zizmonkey4277]

What a huge waste of time this would be for doctors and staff. As if people don’t wait long enough at the doctors office. Smh we are doomed

[@ffifi9093]

It's so funny and ridiculous! Someone calling your name and this is a problem??!

[@dailealexander2055]

It's a problem because the staff at this office keep calling him by the WRONG name & the WRONG personal pronouns -- even after he repeatedly corrects them (politely & calmly, too, might I add). Let me ask you something -- how would YOU feel if you ever walked into a doctor's office for an appointment & the staff kept referring to you by the wrong name & gender, even after you corrected them? What if you kept insisting, "No, that's wrong, I'm a girl" & they just kept replying, "Sure, whatever you say, sir" -- you're telling me you'd be totally fine with that? You'd just let them call you by whatever name & whichever gender pronouns they wanted? No, I'm sure you'd be frustrated & outraged. And rightly so! Calling a transgender person by the wrong name/gender pronouns is considered insulting, humiliating for them & HUGELY insensitive -- it's one thing to make an honest mistake, but once the person corrects you, you should make a note of their preferred name/pronouns so it doesn't happen again. It's humiliating & dehumanizing treatment (like the way Joe is initially treated by the staff in the video) that stops most transgender & nonbinary individuals from going to the doctor & receiving the medical/dental care they need. It's not 1955 anymore, it's 2021 -- there's literally no excuse for medical offices to be insensitive toward transgender, genderfluid & nonbinary people anymore. Remember, a little respect, compassion & understanding can go a LONG way! 😊🌈❤

[@drogba0019]

Calling a woman by her real name = discrimination. This world is absolutely doomed 🤦🏼‍♂️

[@sashas3362]

Furthermore, transgender patients shouldn't need to ask you to use a different gender pronoun. Healthcare pros shouldn't be going around assuming peoples gender identities based on their sex or appearance or their name. Instead of using an *presumed* pronoun based on appearances until told to use a different pronoun by the patient they should refrain from using ANY gender specific pronouns unless they have determined that it is OK to use a gender specific pronoun and what pronoun to use. Until then they should not use any gender specific pronouns.

[@lucijanlupic5424]

I would rather quit my job and be homeless then do this shit

[@Dave-if5qj]

Medical professionals are trained To deal with facts Insane having to play Along With.thid game

[@josie_grossyy]

Its an IT. LOL

[@emilys4566]

Not funny at all, I see it’s a 3 year old comment but that didn’t stop me from saying this

[@lupcodimovski7072]

Why apologize, it's hard to keep up to all these new genders coming out, dont know whos who or who's what. A what ever....... Little house on a prairie is very very normal now..

[@jenniferplatts174]

You might view yourself as one sex, but your biology states otherwise. We are not interchangable on a medical level. Your expectations need to be realistic to. ......your biology dictates your care, no matter what u think or feel. Patience on all levels , thank you.