{"id":37549,"date":"2018-03-18T05:15:09","date_gmt":"2018-03-18T05:15:09","guid":{"rendered":"https:\/\/essays.homeworkacetutors.com\/2018\/03\/marginalization-of-transgender-women\/"},"modified":"2018-03-18T05:15:09","modified_gmt":"2018-03-18T05:15:09","slug":"marginalization-of-transgender-women","status":"publish","type":"post","link":"https:\/\/www.colapapers.com\/us\/marginalization-of-transgender-women\/","title":{"rendered":"Marginalization of Transgender Women"},"content":{"rendered":"
\n

As a family nurse practitioner (FNP) student, it is
\nimportant to provide unbiased and culturally-competent healthcare services
\nregardless of age, race, religion, socio-economic status, or gender
\norientation.\u00a0 Transgender<\/em> is an umbrella term for individuals who identify with a
\ngender different than what was assigned at birth\u00a0(World Health
\nOrganization, 2018).<\/strong>\u00a0 As with any other subpopulation, transgender
\nwomen come from all walks of life and are mothers, fathers, sisters, and brothers
\nin their families.\u00a0 Despite their
\nprevalence and presence all throughout history, they are classified as a
\nmarginalized population that struggle to receive inequitable healthcare due to
\ntheir gender orientation\u00a0(Bradford, Reisner, Honnold, &
\nXavier, 2013).\u00a0 The focus of this paper is to evaluate the
\nmarginalization of transgender women.\u00a0 It
\nwill include the current prevalence, socioeconomic aspects, social justice and
\nits relationship to health disparities, ethical issues, plans for action to
\naddress the health issue, and conclude with a summary of key points.\u00a0 <\/p>\n

Background<\/h2>\n

An individual\u2019s gender identity is based on their personal judgement of whether they identify as male, female, or neither sex.\u00a0 Some transgender people identify themselves with their transitioned gender: female to male, male to female, or members of a third sex\u00a0(World Health Organization, 2018).\u00a0 Legal identification documents that contradict a person\u2019s birth gender may subject transgender individuals to punitive laws and discriminatory policies.\u00a0 According to the World Health Organization (2018), marginalized populations such as transgender women are often stigmatized and criminalized for their contradictory gender identity from their birth gender; affecting their ability to access health care services, social protection, and equal opportunity for employment.\u00a0 Transgender women are considered one of the five subpopulations that are disproportionately affected by HIV because their increased risk exposure\u00a0(Divan, Cortez, Smelyanskaya, & Keatley, 2016).\u00a0 The other subpopulations that World Health Organization identifies are: intravenous drug abusers, men who have sex with men, sex workers, and prisoners.\u00a0 In some countries, transgender women are 49-80 times more likely to have HIV compared to non-transgender adults of reproductive age, an estimated 19% prevalence worldwide\u00a0(World Health Organization, 2018).\u00a0 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.\u00a0 <\/p>\n

Another essential component for gaining wider
\nrecognition for transgender health issues is required revision of the International statistical classification of
\ndiseases and related health problems <\/em>(ICD), the standard diagnostic
\nreference for epidemiology, health management, and clinical practice.\u00a0 The current version, ICD-10, \u201cgender identity
\ndisorders\u201d were categorized under \u201cmental and behavioral disorders\u201d.\u00a0 The next edition, ICD-11, which is due to be
\npublished in 2018 will classify transgender health issues in a new category of
\n\u201cgender incongruence\u201d\u00a0(Robles, et al., 2016).\u00a0 <\/p>\n

On June 29, 2015, Nevada became the 10th<\/sup>
\nstate that banned transgender discrimination in healthcare and insurance.\u00a0 Nevada State\u2019s insurance commissioner
\ndetermined that the state and administrative code would \u201cprohibit the denial,
\nexclusion or limitation of benefits relating to coverage of medically necessary
\nhealth care services on the basis of sex as it relates to gender identity or
\nexpression\u201d\u00a0(National Center for Transgender
\nEquality, 2015).\u00a0 This inclusion for transition-related
\nhealthcare has since made it more accessible for transgender individuals to
\nmove forward with gender assignment surgeries which were formerly not covered
\nby health insurance carriers.\u00a0 <\/p>\n

Socioeconomics<\/h2>\n

The ways in which marginalization impacts a transgender person\u2019s life are interconnected to socioeconomics derivatives.\u00a0 Stigma and transphobia in the community hearten a society of isolation, poverty, violence, lack of socioeconomic support systems, and compromised health outcomes since each circumstance cohabits and exacerbates the other\u00a0(Divan, Cortez, Smelyanskaya, & Keatley, 2016).\u00a0 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.\u00a0 This behavioral trend typically results in the lack of opportunities for education and further disregard to their need for mental and physical health needs.\u00a0 The hostile environment that envelopes the young transgender community fail to understand their needs and threaten their safety by being discordant to provide sensitivity to health and social requirements.\u00a0 Such discrimination and exclusion criteria fuel a sense of vulnerability, resulting in fewer opportunities to advance education, increased odds of unemployment, higher risk for homelessness and poverty\u00a0(Lenning & Buist, 2013).\u00a0 <\/p>\n

Transgender workers are the most marginalized in the
\nworkplace, often excluded from gainful employment and undergo severe
\ndiscrimination during all phases of the employment process (including
\nrecruitment, training, benefits, and advancement opportunities)\u00a0(Divan,
\nCortez, Smelyanskaya, & Keatley, 2016).\u00a0 These workplace adversaries incubate
\npessimism and internalized transphobia in transgender people and ultimately
\ndiscourage attempts to applying to many professional careers.\u00a0 Extreme limitations in employment often lead
\ntransgender people to uphold positions that have limited opportunities for
\ncareer growth and development such as beauticians, entertainers or sex
\nworkers.\u00a0 The high prevalence of
\nunemployment and low-income, high-risk unstable jobs promote the cycle of
\nhomelessness and poverty.\u00a0 In 2016, a
\nsocioeconomic study reported the estimated annual incomes of two groups: A \u2013
\nsocioeconomic and racial privileged (n=239<\/em>;
\ntransgender, with associate\u2019s degrees and were non-Latino, White), B \u2013
\neducational privileged (n=191<\/em>;
\ntransgender, with bachelor\u2019s degrees and people of color).\u00a0 Group A reported annual household incomes of
\n$60,000 or more and Group B reported total household incomes of $10,000 or less
\nper year\u00a0(Budge, Thai, Tebbe, & Howard,
\n2016).\u00a0 <\/p>\n

Social Justice<\/h2>\n

The transgender society continue to endure adversarial
\nchallenges despite the increased social awareness of gender orientation and
\ngender identity portrayed in media, news, politics, and even early education in
\nrecent years.\u00a0 The ever growing
\nprevalence of the lesbian, gay, bisexual, transgender, queer (LGBTQ) community\u2019s
\npresence in society continue to surpass the rate of open-mindedness and
\nacceptance amongst coexisting citizens and is demonstrated by unequal societal
\nstructures\u00a0(Budge, Thai, Tebbe, & Howard,
\n2016).\u00a0 The antagonistic perceptions they endure from
\nthe public are linked to ambiguity in gender<\/em>
\n\u2013 the binary classification of identification and differentiation in western
\nsociety\u00a0(Neufeld, 2014).\u00a0 The severity of marginalization deepens when
\ntransgender individuals reside in smaller remote communities where resources
\nare limited and the prominent impact of colonization isolate transgender
\nindividuals.\u00a0 The collective consequence
\nof family, social, and institutional transphobia contributes to the increased
\nrisk of mental health issues, frequency of substance abuse, and prevalence of
\nsexually transmitted infections within the transgender population\u00a0(Lenning &
\nBuist, 2013).\u00a0 Social justice for transgender patients in
\nhealthcare should translate to the equally entitled fair distribution of
\nhealthcare resources with unbiased regard to their gender identity, preferred
\nname in the electronic medical record (EMR).\u00a0
\nFurthermore, billing for medical procedures should be exceedingly
\nscrutinized to ensure that the billing name and pronoun match the patient\u2019s
\ninsurance identity\u00a0(Hann, Ivester, & Denton,
\n2017).\u00a0 <\/p>\n

Ethical Issues<\/h2>\n

The principal ethical issue that concerns the transgender community is the inequality of healthcare access.\u00a0 Transgender individuals that contribute to the society should be provided equal access to healthcare as a non-transgender individual who mirrors the same type of existence in society.\u00a0 Transgender care should have equal focus in medical education, research and funding.\u00a0 Extending to healthcare access for transgender inmates in prison, Amendment VIII of the United States Constitution should be enforced.\u00a0 \u201cExcessive bail should not be required, nor excessive fines imposed, no cruel and unusual punishments inflicted\u201d\u00a0(United States Constitution, Amendment VIII).<\/p>\n

Plan for Practice<\/h2>\n

Considering that Nevada is one of ten states that
\npassed a law which bans discrimination of transgender persons in healthcare and
\ninsurance, it is imperative to have a plan for practice that echoes the same
\nintent.\u00a0 Forecasting the future as an FNP
\nin the clinic setting, the three actions for practice that I plan to implement
\nare: 1) Encouraging of cultural competency training amongst staff in regards to
\nLGBTQ population.\u00a0 This includes
\nincorporating written nondiscrimination statements specifically to protect
\ntransgender rights\u00a0(Hayhurst, 2016).\u00a0 This can be measured implementing an annual
\ncompetency written test, to assess retained knowledge and also provide
\nopportunity to refresh their practice.\u00a0
\nAnother method of outcome measurement can be the report card from a
\ntransgender (secret-shopper) patient\u2019s care experience.\u00a0 2) Establishing transgender-friendly
\nenvironment from arrival.\u00a0 Offering small
\nclues such as a rainbow sticker or flag at the check-in counter or adding LGBTQ
\ncommunity literature in the waiting room\u00a0(Hayhurst, 2016).\u00a0 The outcome of this intervention can be
\nmeasured by asking a transgender patient if they were able to identify LGBTQ
\nclues in the clinic and if it made them feel more welcomed to the
\npractice.\u00a0 3) Gender neutral restrooms
\ncan be simply implemented by eliminating any gender specific signs (women or
\nmen)\u00a0(London, 2014).\u00a0 Measuring the outcome of this change can be
\ndetermined by implementing random audits \u2013 monitoring if patients and visitors
\ndo not hesitate to use the restroom because of a gender exclusive sign.<\/p>\n

Stigma and lack of legal recognition remain the backbone to structural barriers (laws, policies, and regulations), impeding adequate healthcare provisions to transgender women in 40 different United States\u00a0(Bradford, Reisner, Honnold, & Xavier, 2013).\u00a0 Transgender individuals who exercise human fundamental rights \u2013 to life, liberty, equality, health, privacy, speech, and expression are often dismissed by their own families.\u00a0 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 \u2013 which heighten their risk for HIV infection\u00a0(Divan, Cortez, Smelyanskaya, & Keatley, 2016).\u00a0 Health disparities continue due to adversarial issues that encompass their lives and they are less likely to seek healthcare treatment in a timely or preventative manner.\u00a0\u00a0 <\/p>\n

I hope that research focused on the transgender
\npopulation continues in the future, as there seems to be a lack of new
\nknowledge and slow implementation to changing the approach to healthcare
\npractice to better address transgender concerns.\u00a0 As mentioned in my plan for practice, I am
\nquite confident that I will succeed in implementing those actions for
\nchange.\u00a0 They are all fairly simple
\ninterventions that are of minimal cost and can benefit both the practice
\ngenerate income (with new patients) and transgender individuals to seek
\nhealthcare in a transgender-friendly environment. <\/p>\n

References<\/h2>\n

Bradford, J., Reisner, S. L., Honnold, J.
\nA., & Xavier, J. (2013). Experiences of transgender-related discrimination
\nand implications for health: Results from the Virginia transgender health
\ninitiative study. American Journal of Public Health, 103<\/em>(10), 1820-1829.
\ndoi:10.2105\/AJPH.2012.300796<\/p>\n

Budge, S. L., Thai,
\nJ. L., Tebbe, E. A., & Howard, K. A. (2016). The intersection of race,
\nsexual orientation, socioeconomic status, trans identity, and mental health
\noutcomes. The Counseling Psychologist, 44<\/em>(7), 1025-1049.
\ndoi:10.1177\/0011000015609046<\/p>\n

Divan, V., Cortez,
\nC., Smelyanskaya, M., & Keatley, J. (2016). Transgender social inclusion
\nand equality: A pivotal path to development. Journal of the International
\nAids Society, 19<\/em>(3). doi:10.7448\/IAS.19.3.20803<\/p>\n

Hann, M., Ivester,
\nR., & Denton, G. D. (2017). Bioethics in practice: Ethical issues in the
\ncare of transgender patients. The Ochsner Journal, 17<\/em>(2), 144-145.
\nRetrieved from https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5472072\/<\/p>\n

Lenning, E., &
\nBuist, C. L. (2013). Social, psychological and economic challenges faced by
\ntransgender individuals and their significant others: Gaining insight through
\npersonal narratives. Cultures, Health & Sexuality, 15<\/em>(1), 44-57.
\ndoi:10.1080\/13691058.2012.738431<\/p>\n

London, J. (2014).
\nLet\u2019s talk about bathrooms. Diversity Best Practices<\/em>. Retrieved from
\nhttps:\/\/www.diversitybestpractices.com<\/p>\n

National Center for
\nTransgender Equality. (2015). Nevada becomes tenth state to ban transgender
\nhealth exclusions<\/em>. Retrieved from National Center for Transgender Equality:
\nhttps:\/\/transequality.org\/nevada-becomes-tenth-state-to-ban-transgender-health-exclusio<\/p>\n

Neufeld, A. C.
\n(2014). Transgender therapy, social justice, and the northern context:
\nChallenges and opportunities. Canadian Journal of Counseling and
\nPsychotherapy, 48<\/em>(3), 218-230. Retrieved from
\nhttp:\/\/cjc-rcc.ucalgary.ca\/cjc\/index.php\/rcc\/article\/viewFile\/2716\/2530<\/p>\n

Robles, R., Fresan,
\nA., Vega-Ramirez, H., Cruz-Islas, J., Rodriguez-Perez, V., Dominguez-Martinez,
\nT., & Reed, G. M. (2016). Removing transgender identity from the
\nclassification of mental disorders: a Mexican field study for ICD-11. The Lancet
\nPsychiatry, 3<\/em>(9), 850-859. doi:10.1016\/S2215-0366(16)30165-1<\/p>\n

United States
\nConstitution, Amendment VIII. (n.d.). Retrieved from
\nhttps:\/\/constitutioncenter.org\/interactive-constitution\/amendments\/amendment-viii<\/p>\n

World Health
\nOrganization. (2018). Transgender people<\/em>. Retrieved from World Health
\nOrganization: http:\/\/www.who.int\/hiv\/topics\/transgender\/en\/<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

As a family nurse practitioner (FNP) student, it is important to provide unbiased and culturally-competent healthcare services regardless of age, race, religion, socio-economic status, or gender orientation.\u00a0 Transgender is an umbrella term for individuals who identify with a gender different than what was assigned at birth\u00a0(World Health Organization, 2018).\u00a0 As with any other subpopulation, transgender […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7418,7468,5788],"tags":[7419,3319,5337,5587,5586,249],"class_list":["post-37549","post","type-post","status-publish","format-standard","hentry","category-affordable-essay-writing-service","category-essay-examples-health-and-social-care","category-health-and-social-care","tag-academic-paper","tag-assignment-help","tag-dissertation-writing","tag-essay-writing","tag-online-tutoring","tag-write-my-paper"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/posts\/37549","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/comments?post=37549"}],"version-history":[{"count":0,"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/posts\/37549\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/media?parent=37549"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/categories?post=37549"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/us\/wp-json\/wp\/v2\/tags?post=37549"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}