1. Machuca, Christina BSN, RN

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Dear Editor,


As the head nurse of an acute inpatient psychiatric unit, I was touched by the article "Gender Affirming and Supportive Care for Gender Diverse Youth" by Lexis Rivers in the January/March 2021 issue of the Journal of Pediatric Surgical Nursing. I cared for a patient within my facility who identified as a transgender female-to-male. This young person had yet to come out to his family and had only during the admission process revealed to nursing that he identified as transgender. He had not started any hormone therapy, blockers, or surgery but felt comfortable speaking up about his preference. At the time, he did not want his family to be notified of what he had disclosed to the medical team. He requested that staff address him in his proper pronouns as he/him/his and also utilize his chosen name.


This resulted in some challenges for staff who were not knowledgeable about transgender care. It was difficult for some staff to understand because he still presented as "female" in his outward appearance, vocal tone, and mannerisms. Staff had a hard time consistently respecting his wishes of using proper pronouns and chosen name. As a huge ally within the LGBTQIA+ community, I was approached by the unit chief and asked if I could provide some education to members of the staff.


As a mother to a son who identifies as transgender (female-to-male), I personally understood the difficulties in this patient population firsthand. I collaborated with my son to develop a presentation for staff and sought guidance on how to best care for transgender patients. We co-presented this information to staff and were well received. This provided a unique opportunity for the staff to speak freely with a person who identifies as transgender and for us to answer any questions they had. This has now become a required diversity training within my facility for all nursing staff. As stated in the article, the usage of proper pronouns is needed and necessary; this is the starting point in building the trust required between the patient and the nurse.




Christina Machuca, BSN, RN