title: Transgender identity and health care: implications for psychosocial and physical evaluation.
abstract: OBJECTIVE
  The purpose of this article is to educate nurse practitioners (NPs) regarding: (a) the definition and range of transgenderism, (b) social influences on transgender persons, and (c) health care for transgender persons.
  
  
  METHODS
  Data sources include review of the literature in the areas of gender, gender identity, marginalized populations, and gender transition. Personal communication was also utilized.
  
  
  CONCLUSIONS
  Transgender persons remain marginalized and may remain closeted and at risk for negative psychosocial consequences. For those that do come out, other issues present, including the navigation of gender transition and psychosocial and physical changes that may be positive and/or negative. Examples of positive effects may include satisfaction of living authentically and decrease in depression. Negative effects may include social discrimination and loss of relationships. To provide holistic care, NPs need to be aware of transgender lives in social context and of their healthcare needs.
  
  
  CONCLUSIONS
  Suggestions for cultivating a supportive healthcare environment include the usage of sensitive language and an appropriate health history and physical examination. Further, to help rectify the knowledge deficit regarding transgender care among healthcare providers, NP educators and preceptors may utilize this article as a resource in their work with students.
authors.affiliation: Orvis School of Nursing, University of Nevada, Reno, NV 89557, USA. aramburu@unr.edu
authors.forename: Christine Aramburu
authors.initials: CA
authors.lastname: Alegria
mesh_terms: D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008487:Medical History Taking; D009722:Nurse Practitioners; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D010808:Physical Examination; D009626:Terminology as Topic; D014189:Transsexualism / Q000451:nursing / Q000523:psychology