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CHNs supporting community wisdom and voice within the gender diverse…
CHNs supporting community wisdom and voice within the gender diverse community
Curiosity
CHNs can engage with their gender diverse clients by being "interested inquisitive, and open" (Doane & Varcoe, p. 139, 2021) to their situation and lived experiences.
Gender diverse individuals experience higher rates of discrimination in health care settings due to lack of education and understanding (McDowell & Bower, 2016). While it may seem uncomfortable to some nurses at first, the best way that nurses can relate to gender diverse clients is by asking questions such as:
"I see there is a name listed here on your wristband. Would you like me to call you by that name, or is there another name you would prefer?"
"My pronouns are
_
, what are your preferred pronouns?"
We feel that CHNs who are familiar with LGBT+ and gender diverse clients need to practice intentional curiosity in an effort to avoid homogenizing the client's experience. Each person, gender diverse or not, has a unique set of circumstances and needs that the nurse should work to understand and honour.
CHNs need to be brave and vulnerable enough to ask questions when they are unsure of how best to help or refer to the client. The nurse should "develop skillfulness to respectfully and confidently question in order to develop the capacity to traverse between knowing and not knowing" (Doane & Varcoe, p. 142, 2021).
Commitment
Commitment requires nurses to identify their values and continuously apply those values to their work (Doane & Varcoe, 2021).
The nurse must respect their gender diverse clients' autonomy, even if they are still in the process of understanding their motivations for those choices.
CHNs show their commitments by means understanding the limited resources available to meet the client's needs, but doing everything in their power to improve their situation (Doane & Varcoe, 2021). For gender diverse individuals this might mean the nurse has to take on tasks similar to a social worker to find out if there is funding available for hormone therapy, housing, etc.
Nurses must be committed to seeing and embracing their differences with gender diverse clients. In most instances, these clients will express their gender in a way that is unfamiliar to the nurse. What the client feels is normal or right might conflict with the nurse's values or social norms, but this is a time where the nurse can lean in and embraces these differences (Doane & Varcoe, 2021). More often than not our commonalities outnumber our differences.
Competence
Nurses can demonstrate competence with the gender diverse community by using gender-affirming language, being knowledgeable about hormone therapy, and health inequities this community faces (McDowell & Bower, 2016).
The nurse must work with the client to find ways to complete their duties as a nurse without inflicting harm upon their clients (Doane & Varcoe, 2021). An example of this might be adapting assessments to allow gender diverse clients to feel safe in their environment (i.e. keeping their chest or perineum/genitals covered during assessment when appropriate).
The CHN must realize that being competent is a journey not a final destination. Competence is client specific and requires the nurse to engage in relational inquiry to understand what the client needs of the nurse (Doane & Varcoe, 2021). We feel that this is closely linked to curiosity as curiosity is a first step to assessing competence with any given client.
Correspondence
Correspondence requires the nurse to relate to their clients in ways that are important to them (Doane & Varcoe, 2021).
Put simply, correspondence is about listening to our clients.
How CHNs correspond will not only shape our client's experiences, but also our own experiences as nurses (Doane & Varcoe, 2021). We may notice different things about our clients depending on the frame of mind we enter into situations with.
The nurse must meet the clients where they are at energetically. If a gender diverse client came into the clinic crying, explaining that they had suffered some bullying in the form of misgendering, the nurse should meet their energy by taking a gentle approach to finding out more in order to help them.
Compassion
The transgender and non-binary community is a community that is both independent and interwoven into the larger 2SLGBT+ community.
Nurses must work to understand who their gender diverse clients are, what they feel is important, and what there needs might be (Doane & Varcoe, 2021).
Nurses must bear witness to the suffering and challenges that gender diverse individuals face at home, in the community, and in health care settings (Doane & Varcoe, 2021). By not shying away from their suffering nurses can begin to understand the lived experiences of gender diverse people and "be with" them through their health challenges (Doane & Varcoe, 2021).
Ben Ferguson and Hasti Halakoeei
