Marginalization of Transgender Women

Marginalization of Trans sexual urge WomenAs a family nurse practitioner (FNP) student, it isimportant to provide unbiased and cultur ally-competent wellnessc be servicesregardless of age, race, religion, socio-economic status, or genderorientation. Transgender is an umbrella term for individuals who identify with agender different than what was assigned at birth(World HealthOrganization, 2018). As with both other subpopulation, transgenderwomen come from all walks of sprightliness and be mothers, fathers, sisters, and brothersin their families. Despite theirprevalence and presence all byout history, they are classified as amarginalized population that struggle to receive inequitable wellnesscare due totheir gender orientation(Bradford, Reisner, Honnold, &Xavier, 2013). The cerebrate of this paper is to evaluate themarginalization of transgender women. Itwill include the incumbent prevalence, socioeconomic aspects, social justice andits relationship to health disparities, eth ical plys, plans for action toaddress the health issue, and cease with a summary of key points. BackgroundAn individuals gender individualism 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 counterbalance a persons birth gender may subject transgender individuals to punitive laws and discriminatory policies. agree 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 hazard for physical exertion. Transgender women are considered one of the five subpopulations that are disproportionately affected by human immu nodeficiency virus because their increased take a chance exposure(Divan, Cortez, Smelyanskaya, & Keatley, 2016). The other subpopulations that World Health Organization identifies are intravenous drug abusers, men who afford sex with men, sex workers, and prisoners. In some countries, transgender women are 49-80 times much likely to have HIV 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 immanent 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 clinical radia tion diagram. The current version, ICD-10, gender identitydisorders were categorized chthonian mental and behavioral disorders. The next edition, ICD-11, which is due to bepublished in 2018 will classify transgender health issues in a new category ofgender incongruence(Robles, et al., 2016). On June 29, 2015, Nevada became the 10thstate that banned transgender inequality in healthcare and insurance. Nevada States insurance commissionerdetermined that the state and administrative code would b needball the denial,exclusion or limitation of benefits relating to coverage of medically necessaryhealth care services on the basis of sex as it relates to gender identity orexpression(National Center for TransgenderEquality, 2015). This cellular inclusion for transition-relatedhealthcare has since made it more accessible for transgender individuals tomove forward with gender assignment surgeries which were formerly not coverby health insurance carriers. SocioeconomicsThe ways in which margi nalization impacts a transgender persons life are interconnected to socioeconomics derivatives. 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(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 education and further disregard to their need for mental and physical health needs. The contrasted environment that envelopes the young transgender community fail to understand their needs and threaten their safety by macrocosm discordant to provide sensitivity to health and social requirements. Such discrimination and exclusion criteria fuel a sense of vulnerability, resulting in fewer opportu nities 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 courses. 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 fluid jobs promote the cycle ofhomelessness and poverty. In 2016, asocioeconomic take aim reported the estimated annual incomes of two gr oups A socioeconomic and racial privileged (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 conserve to endure adversarialchallenges despite the increased social awareness of gender orientation andgender identity represent in media, news, politics, and even early education inrecent years. The ever growingprevalence of the lesbian, gay, bisexual, transgender, display (LGBTQ) communityspresence in society keep to surpass the rate of open-mindedness andacceptance amongst coexist citizens and is demonstrated by unequal societalstructures(Budge, Thai, Tebbe, & Howard,2016). The antagonistic perceptions they endure fromthe public are linked to ambiguity in gender the bin ary classification of identification and differentiation in westernsociety(Neufeld, 2014). The cogency of marginalization deepens whentransgender individuals reside in underageer remote communities where resourcesare limited and the prominent impact of colonisation isolate transgenderindividuals. The collective consequenceof family, social, and institutional transphobia contributes to the increasedrisk of mental health issues, frequency of burden abuse, and prevalence ofsexually transmitted infections within the transgender population(Lenning &Buist, 2013). Social justice for transgender patients inhealthcare should hand over to the equally entitled fair distribution ofhealthcare resources with unbiased regard to their gender identity, preferred fall upon 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 principal 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 same 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 United States Constitution should be enforced. Excessive bail should not be required, nor excessive fines imposed, no cruel and unusual punishments inflicted(United States Constitution, Amendment VIII).Plan for exerciseConsidering 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 three actions for practi ce that I plan to implementare 1) Encouraging of cultural competency training amongst staff in regards toLGBTQ population. This includesincorporating write nondiscrimination statements particular propositionally to protecttransgender rights(Hayhurst, 2016). This depose be calculated implementing an annualcompetency written test, to assess kept up(p) knowledge and also provideopportunity to refresh their practice.Another method of outcome measurement can 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 can 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 monitor if patients and visitorsdo not hesitate to use the restroom because of a gender exclusive sign.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(Bradford, Reisner, Honnold, & Xavier, 2013). Transgender individuals who exercise human fundamental rights to life, liberty, equality, health, privacy, speech, and expression are often pink-slipped by their own families. These experiences of severe stigma and marginalization continue to negatively impact their lives by separate 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(Divan, Cortez, Smelyanskaya, & Keatley, 2016). Health disparities continue due to adversarial issues that encompass their lives and they are less likely to test healthcare treatment in a timely or preventative manner. I hope that research focused on the transgenderpopulation continues in the future, as there seems to be a lack of newknowledge and slow 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 frankinterventions that are of minimal cost and can benefit both the practicegenerate 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 healthinitiative study. American Journal of man Health, 103(10), 1820-1829.doi10.2105/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.doi10.1177/0011000015609046Divan, 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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