Transgender adolescents exhibit incongruences between their natural birth sex and their present gender identities. These adolescents may identify as either females or males or even elsewhere on the gender band. The psychosomatic outcomes as well as perils of transgender adolescent have been more widely recognized in the recent past. This has therefore necessitated the need for medical and psychosocial care to these adolescents by medical practitioners (Guss, Shumer & Katz-Wise, 2016). However, provision of transgender hormone treatment to adolescents should follow conventional exemplars, and adoption of more judicious approaches.
Recent studies have revealed that gender dysphoria therapy has been useful in combating the health risks that transgender adolescents are likely to suffer as a result of their lack of uniformity in their current gender identities and their birth sex. As a nurse practitioner therefore, one should familiarize themselves with the assortment of medication alternatives as well as referral means that can be recruited in the cases of transgender adolescents. This is to enable medical practitioners (nurses) to be able to offer both convivial and optimum care to these transgender adolescents.
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There is sufficient evidence to support the basis of the argument that nurse practitioners should administer transgender hormone therapy to transgender adolescents. As mentioned before, transgender hormone therapy resects conventional medical paradigms and also requires the adoption of more judicious approaches. The judicious approach deployed in transgender hormone therapy is informed consent. Cavanaugh, Hopwood and Lambert (2016) shed some light on the ethical and legal prerequisites prior to administration of gender dysphoria treatment. They described informed consent as the legal and ethical basis for most patient care decisions. Nurse practitioners are required to communicate the projected health benefits as well a prospective risks of administering transgender hormone therapy to the adolescents, their parents or guardians before the onset of treatment. This is due to the fact that the adolescent patients are too young to sometimes comprehend and weigh out the options at their disposal. The WPATH Standards of care also place a strong emphasis on the need for patients to go through mental health evaluation before being permitted to access gender-affirming therapy (Cavanaugh, Hopwood & Lambert, 2016). The mental health assessment serves two significant purposes: the valuation of gender dysphoria and identity. Surgical interventions can only be conducted after reception of referral letters from qualified mental health professionals, and a 12-month period of “living in a gender role that is congruent with one’s gender identity.” (Cavanaugh, Hopwood & Lambert, 2016).
Tefler, Tollit, Pace and Pang (2018) also had their say on the legal requirements for the administration of transgender hormone treatment for transgender adolescents. They revealed that even though it necessary to offer these teenagers gender-affirming hormone therapy, certain stipulation of the law have to be followed before pursuing surgical interventions. The current law governing administration of transgender therapy to transgender adolescents requires that practitioners to first evaluate the adolescents’ abilities to deliver informed consent for such treatments. Those who are deemed to be not competent enough to provide such consents should have their parents or guardians provide informed consent on their behalf (Tefler, Tollit, Pace & Pang, 2018). There are also general ethical and professional principles governing the administration of transgender therapy to adolescents. These tenets include use of respectful and affirming language, avoid causing harm to these adolescent patients, consideration of socio-cultural factors in the delivery of such treatments and individualization of care (Tefler, Tollit, Pace & Pang, 2018).
In conclusion, primary care givers (nurse practitioners in this case) specializing in the field of transgender therapy should always be optimally placed to receive transgender adolescent patients for both medical care and creating an optimal medical environment under which they receive their medical care. This patient population has been historically marginalized and there is an increasing need for the government to invest more in this group of patients. In cases where nurse practitioners may not feel ready enough to conduct hormonal treatments to these transgender adolescents, creation of safe medical environments, screening and appropriate referral to medical care and mental health services is exceedingly necessary.
References
Cavanaugh, T., Hopwood, R., & Lambert, C. (2016). Informed consent in the medical care of transgender and gender-nonconforming patients. AMA Journal of Ethics, 18 (11), 1147-1155. doi: 10.1001/journalofethics.2016.18.11.sect1-1611.
Gus, C., Shumer, D., & Katz-Wise, S.L. (2016). Transgender and gender nonconforming adolescent care: Psychosocial and medical considerations. Current Opinions on Pediatrics, 26 (4), 421-426. doi: [10.1097/MOP.0000000000000240]
Tefler, M., Tollit, M., Pace, C., & Pang, K. (2018). Australian Standards of care and treatment guidelines for trans and gender diverse children and adolescents. The Royal Children’s Hospital; Melbourne. Retrieved November 14, 2018 from https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf
