Marginalization of Transgender Women

Marginalization of Trans sex WomenAs a family nurse practitioner (FNP) student, it isimportant to provide unbiased and cultur bothy-competent wellnessc ar servicesregardless of age, race, religion, socio-economic status, or sexual activityorientation. Transgender is an umbrella term for individuals who identify with agender different than what was assigned at birth(World HealthOrganization, 2018). As with any other subpopulation, transgenderwomen come from all walks of life and are mothers, fathers, sisters, and brothersin their families. Despite their prevalence and presence all throughout history, they are classified as amarginalized population that struggle to become inequitable healthcare due totheir gender orientation(Bradford, Reisner, Honnold, &Xavier, 2013). The focus of this paper is to evaluate themarginalization of transgender women. Itwill include the current prevalence, socioeconomic aspects, social rightness andits relationship to health disparities, ethical issues, plans for action toaddress the health issue, and conclude with a summary of key points. BackgroundAn individuals gender identicalness is based on their personal judgement of whether they identify as male, female, or neither sex. Some transgender people identify themselves with their transitioned gender female to male, male to female, or members of a third sex(World Health Organization, 2018). Legal identification documents that contradict a persons birth gender may subject transgender individuals to penitentiary laws and discriminatory policies. According to the World Health Organization (2018), marginalized populations such as transgender women are often stigmatized and criminalized for their contradictory gender individuality from their birth gender touch on their ability to access health care services, social protection, and equal opportunity for example. Transgender women are considered one of the five subpopulations that are disproportionately affected by human immunodefi ciency virus because their increase seek exposure(Divan, Cortez, Smelyanskaya, & Keatley, 2016). The other subpopulations that World Health Organization identifies are intravenous drug abusers, men who have sex with men, sex workers, and prisoners. In some countries, transgender women are 49-80 times more than likely to have human immunodeficiency virus compared to non-transgender adults of reproductive age, an estimated 19% prevalence worldwide(World Health Organization, 2018). In addition to the HIV epidemic amongst transgender population, mental health issues including depression, anxiety, mood disorders, and suicidal ideations were the most commonly identified health issues in researched publications. Another essential component for gaining widerrecognition for transgender health issues is required revision of the International statistical classification ofdiseases and related health problems (ICD), the standard diagnosticreference for epidemiology, health management, and clin ical practice. The current version, ICD-10, gender identitydisorders were categorized under mental and behavioral disorders. The next edition, ICD-11, which is due to bepublished in 2018 will classify transgender health issues in a sweet category ofgender incongruence(Robles, et al., 2016). On June 29, 2015, Nevada became the 10thstate that banned transgender divergence in healthcare and insurance. Nevada States insurance commissionerdetermined that the state and administrative code would prohibit the denial,exclusion or limitation of benefits relating to coverage of medical examinationly necessaryhealth care services on the basis of sex as it relates to gender identity orexpression(National Center for TransgenderEquality, 2015). This inclusion for transition-relatedhealthcare has since made it more accessible for transgender individuals tomove forward with gender assignment surgeries which were formerly not coveredby health insurance carriers. SocioeconomicsThe ways in which ma rginalization impacts a transgender persons life are interconnected to socioeconomics derivatives. defacement and transphobia in the community hearten a society of isolation, poverty, violence, lack of socioeconomic support systems, and compromised health results since each circumstance cohabits and exacerbates the other(Divan, Cortez, Smelyanskaya, & Keatley, 2016). This is pertains especially to those individuals who express their gender identity from youth, they are often rejected or outcast by their own nuclear families. This behavioral trend typically results in the lack of opportunities for genteelness and further disregard to their need for mental and physical health needs. The hostile environment that envelopes the young transgender community fail to understand their needs and threaten their condom by being discordant to provide sensitivity to health and social requirements. Such discrimination and exclusion criteria fuel a sense of vulnerability, resulting in less oppo rtunities to advance education, increased odds of unemployment, higher risk for homelessness and poverty(Lenning & Buist, 2013). Transgender workers are the most marginalized in theworkplace, often excluded from gainful employment and undergo severediscrimination during all phases of the employment process (includingrecruitment, training, benefits, and advancement opportunities)(Divan,Cortez, Smelyanskaya, & Keatley, 2016). These workplace adversaries incubatepessimism and internalized transphobia in transgender people and ultimatelydiscourage attempts to applying to many professional careers. Extreme limitations in employment often leadtransgender people to uphold positions that have limited opportunities forcareer growth and development such as beauticians, entertainers or sexworkers. The high prevalence ofunemployment and low-income, high-risk unstable jobs promote the cycle ofhomelessness and poverty. In 2016, asocioeconomic study reported the estimated annual incomes of two gro ups A socioeconomic and racial let (n=239transgender, with associates degrees and were non-Latino, White), B educational privileged (n=191transgender, with bachelors degrees and people of color). Group A reported annual household incomes of$60,000 or more and Group B reported total household incomes of $10,000 or lessper year(Budge, Thai, Tebbe, & Howard,2016). Social JusticeThe transgender society continue to endure adversarialchallenges despite the increased social awareness of gender orientation andgender identity portrayed in media, news, politics, and even early education inrecent years. The ever growthprevalence of the lesbian, gay, bisexual, transgender, queer (LGBTQ) communityspresence in society continue to surpass the rate of open-mindedness andacceptance amongst coexisting citizens and is demonstrated by anisometric societalstructures(Budge, Thai, Tebbe, & Howard,2016). The antagonistic perceptions they endure fromthe public are linked to ambiguity in gender the binary classification of identification and differentiation in westboundsociety(Neufeld, 2014). The severity of marginalization deepens whentransgender individuals reside in smaller remote communities where resourcesare limited and the prominent impact of colonization isolate transgenderindividuals. The collective outcomeof family, social, and institutional transphobia contributes to the increasedrisk of mental health issues, frequency of substance abuse, and prevalence ofsexually transmitted transmittals within the transgender population(Lenning &Buist, 2013). Social justice for transgender patients inhealthcare should translate to the equally entitled fair distribution ofhealthcare resources with unbiased regard to their gender identity, preferredname in the electronic medical record (EMR).Furthermore, billing for medical procedures should be exceedinglyscrutinized to ensure that the billing name and pronoun match the patientsinsurance identity(Hann, Ivester, & Denton,2017). Ethical IssuesThe corpus ethical issue that concerns the transgender community is the inequality of healthcare access. Transgender individuals that contribute to the society should be provided equal access to healthcare as a non-transgender individual who mirrors the very(prenominal) type of existence in society. Transgender care should have equal focus in medical education, research and funding. Extending to healthcare access for transgender inmates in prison, Amendment VIII of the coupled States Constitution should be enforced. Excessive bail should not be required, nor excessive fines imposed, no cruel and unusual punishments inflicted( unite States Constitution, Amendment VIII).Plan for PracticeConsidering that Nevada is one of ten states thatpassed a law which bans discrimination of transgender persons in healthcare andinsurance, it is imperative to have a plan for practice that echoes the sameintent. Forecasting the future as an FNPin the clinic setting, the triplet actions for pr actice that I plan to implementare 1) Encouraging of cultural competency training amongst staff in regards toLGBTQ population. This includesincorporating written nondiscrimination statements specifically to protecttransgender rights(Hayhurst, 2016). This tail assembly be measured implementing an annualcompetency written test, to assess retained knowledge and also provideopportunity to refresh their practice.Another method of outcome measurement commode be the report card from atransgender (secret-shopper) patients care experience. 2) Establishing transgender-friendlyenvironment from arrival. Offering smallclues such as a rainbow sticker or flag at the check-in counter or adding LGBTQcommunity literature in the waiting room(Hayhurst, 2016). The outcome of this intervention trick bemeasured by asking a transgender patient if they were able to identify LGBTQclues in the clinic and if it made them feel more welcomed to thepractice. 3) Gender neutral restroomscan be simply implemented by eliminating any gender specific signs (women ormen)(London, 2014). Measuring the outcome of this change can bedetermined by implementing random audits monitoring if patients and visitorsdo not hesitate to use the restroom because of a gender exclusive sign.Stigma and lack of legal recognition inhabit the backbone to structural barriers (laws, policies, and regulations), impeding adequate healthcare provisions to transgender women in 40 different United States(Bradford, Reisner, Honnold, & Xavier, 2013). Transgender individuals who exercise human fundamental rights to life, liberty, equality, health, privacy, speech, and expression are often dismissed by their own families. These experiences of severe stigma and marginalization continue to negatively impact their lives by discriminating against career opportunities, increasing the risk for homelessness, and further projecting them to high risk behavior such as engaging in sex work which heighten their risk for HIV infection(D ivan, Cortez, Smelyanskaya, & Keatley, 2016). Health disparities continue due to adversarial issues that encompass their lives and they are less likely to seek healthcare treatment in a timely or impediment manner. I hope that research focused on the transgenderpopulation continues in the future, as there seems to be a lack of newknowledge and black implementation to changing the approach to healthcarepractice to better address transgender concerns. As mentioned in my plan for practice, I amquite confident that I will succeed in implementing those actions forchange. They are all fairly simpleinterventions that are of minimal cost and can benefit both the practice breed income (with new patients) and transgender individuals to seekhealthcare in a transgender-friendly environment. ReferencesBradford, J., Reisner, S. L., Honnold, J.A., & Xavier, J. (2013). Experiences of transgender-related discriminationand implications for health Results from the Virginia transgender healthinitiati ve study. American Journal of Public Health, 103(10), 1820-1829.inside10.2105/AJPH.2012.300796Budge, S. L., Thai,J. L., Tebbe, E. A., & Howard, K. A. (2016). The intersection of race,sexual orientation, socioeconomic status, trans identity, and mental healthoutcomes. The Counseling Psychologist, 44(7), 1025-1049.inside10.1177/0011000015609046Divan, V., Cortez,C., Smelyanskaya, M., & Keatley, J. (2016). Transgender social inclusionand equality A pivotal path to development. Journal of the InternationalAids Society, 19(3). doi10.7448/IAS.19.3.20803Hann, M., Ivester,R., & Denton, G. D. (2017). Bioethics in practice Ethical issues in thecare of transgender patients. The Ochsner Journal, 17(2), 144-145.Retrieved from https//www.ncbi.nlm.nih.gov/pmc/articles/PMC5472072/Lenning, E., &Buist, C. L. (2013). Social, psychological and economic challenges faced bytransgender individuals and their significant others Gaining insight throughpersonal narratives. 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