Treating Transgender Patients in the ED

Open-mindedness, professionalism and tact can go a long way when caring for transgender patients or, really, any identified group within society.

“Being educated, nonjudgmental and having some idea of how to ask appropriate questions will help with any culture we are unfamiliar with,” said Christine Marshall, an emergency nurse at St. Joseph Emergency Care Center in Orange, California. 

Transgender Patients in the Hospital

1:30 – 2:30 p.m.


Room 413, 414, 415

Marshall will speak on the subject in her presentation, “Transgender Patients in the Hospital,” which will introduce attendees to the lesbian, gay, bisexual, transgender and queer/questioning culture. Specifically, and for starters, she will define terms to describe gender and sexuality and explain the distinct differences between the two. 

“My session is an introduction to the care of transgender patients, and attendees will leave with a greater sense of how they feel about caring for this vulnerable population,” she said. 

Marshall will explore different medical treatments available for transgender patients and related complications. Transgender patients are often on hormones, she said, which can cause many complications, including sterility, blood clots, hypertension, weight gain and other blood and cardiac disorders.

Sex reassignment surgery can also cause complications including infections, strictures and ischemia, she added. 

The discussion will touch on behavioral health issues common in LGBTQ patients and the many barriers they might encounter while in the ED. Marshall explained that members of the LGBTQ population are often at a higher risk for anxiety, depression, suicide, substance use and homelessness.

“LGBTQ people are twice as likely to use drugs and alcohol as well as engage in high-risk sexual behaviors and self-harm,” she said. “About 60 percent of this population has considered suicide, while as much as 41 percent may have attempted suicide.”

Barriers the LGBTQ population encounter in an ED setting include lack of knowledge on the part of staff, discrimination and the feeling of being judged for their appearance, Marshall said. She added that emergency nurses can feel more comfortable communicating with this population if they respect these patients’ preferences and apologize for any mistakes or misunderstandings rather than ignoring them.

“Nurses can overcome the barriers to treating LGBTQ patients by remembering that we don’t have to understand their lifestyle, we just need to respect it and value all differences,” Marshall said. 

LGBTQ Defined

Sex – a matter of the body genetically and phenotypically

Gender – an internal sense of being male, female or other

L – Lesbian: female-identified person attracted to other females

G – Gay: male-identified person attracted to other males

B – Bisexual: person of any gender identity who is attracted to people of the same sex and of various genders

T – Transgender: person whose gender identity does not coincide with the sex or gender they were identified as at birth

Q – Queer: umbrella term for non-heterosexual gender identity

I – Intersex: person born with genitalia, chromosomes or reproductive organs that don’t fit the typical definitions for males or females at birth

A – Asexual: person who doesn’t experience sexual attraction