Creative Nursing

This essay speaks to the legacy value of nurses ‘caring for all people, no matter how they feel about the person's values or lifestyle, including the current issues around gender identity and sexual orientation. This legacy is deeply imbedded in the moral ethics of nursing and supports the proposition that if there isn't caring, it isn't nursing.

In this guest editorial, the author first discusses how gender is a historical and biopsychosocial construct. This means that there are many aspects of gender besides identity, such as gender expressions, roles and experiences. They address how this issue highlights some of these aspects but that these are not exhaustive, given the topic. They highlight how being able to consider our own gender identities, roles, expressions and experiences is an essential starting point if we are to be competent health-care providers. Finally, they suggest that stories might be one way to learn about aspects of gender we may not be as familiar with, as they allow us to connect emotionally, not just cognitively, with these aspects.

This article describes minority stress theory as applied to health disparities and health-care experiences of transgender and gender nonbinary (TGNB) persons. The combination of stigma, social and structural inequalities, and actual discrimination events result in mutually reinforcing dynamics that drive persistent and stubborn disparities in physical and mental health for TGNB persons (Halkitis, Kapadia, Ompad, & Perez-Figueroa, 2015). Together with distrust of the medical system and discomfort of health-care providers in caring for TGNB persons (Smith & Turell, 2017), minority stress contributes to poorer health outcomes and reduced quality of care for sexual and gender minority populations. Ways to reduce health-care-related minority stress for TGNB persons are proposed, with the goal of improving TGNB health and well-being.

The word Two-Spirit is an umbrella term that is used to describe Indigenous peoples who are diverse in terms of their sexual orientation and gender identity, though community-specific definitions and roles for gender and sexual orientation are more extensive and varied. While the terminology of Two-Spirit is recent in its development, Indigenous conceptualizations of diverse gender identities, roles, and sexual orientations have existed since time immemorial and provide important insights into how cultural safety can be incorporated into caring practices. The purpose of this article is to introduce readers to the term Two-Spirit and to provide a broad overview of Indigenous conceptualizations of gender, sexuality, and spirit, to address implications for the nursing profession, and to outline potential applications of this knowledge in practice.

Myths that bring into question the validity of nonbinary genders are commonplace, even within the LGBTQ+ community. The proliferation of these myths compromises the chances of nonbinary people being treated with dignity and respect when they come under the care of health services. Nurses can play an important role in advocating for nonbinary clients and supporting them to build resilience through showing the acceptance and kindness that is at the heart of nursing, but which misconceptions can impede.

The objectives of this article are two-fold. First, it is a personal reflection on the need for reproductive health-care spaces and services where sex and gender binaries are challenged and room for non-binary people is made. Second, it is a critical commentary on why and how cis- and trans-normative understandings of sex and gender form the foundation of reproductive health care as it is currently delivered. Taken together, this article is a call to action for nurses to be creative in challenging sex and gender binaries in their provision of reproductive health care.

LGBTQ youth are at particularly high risk for various health disparities, many of which are often explained using Meyer's Minority Stress Model (2003). Seminars using peer support strategies are helpful in supporting this age group. This article describes a workshop offered at a conference for LGBTQ youth to empower them to build resilience to the many stresses they will experience as they grow into tomorrow's leaders.

Design thinking methodology is a collaborative strategy with the potential to create innovations. Design thinking is being used increasingly in health care. Design jams are interdisciplinary events that bring together experts and community members to collaborate on creative solutions to health-care problems. This article describes the design thinking process and includes reflection on the authors ‘participation in a design jam event aimed to address the knowledge-to-action gap that exists in health care for (LGBTQI2S) people.

An estimated 1.4 million transgender adults live in the United States; this equates to approximately 0.6% of the U.S. population (Lane et al., 2018). Clinical focus on gender dysphoria has significantly increased over the past 30 years (MacCarthy, Reisner, Nunn, Perez-Brumer, & Operario, 2015), with burgeoning evidence from across disciplines documenting the positive outcomes associated with gender-affirming interventions. The purpose of this article is to illustrate how RNs optimize psychosocial, hormonal, and surgical gender-affirming care through performing comprehensive assessments, coordinating care, and providing education and health coaching.

Nurses have the obligation and duty to care for all people (American Nurses Association, 2015), and to treat them with dignity, respect, and compassion (Fowler, 2015). To address equitable care of LGBTQIA people in her community, Jackie Baras, MSN, MBA, RN, serves as LGBT Navigator at Robert Wood Johnson University Hospital/RWJ Barnabas Health in New Brunswick, New Jersey. As a transgender woman, Jackie advocates as liaison and representative for all LGBTQIA patients and employees, focusing on health promotion and disease prevention, addressing knowledge gaps, and identifying community referrals, while working closely with hospital and clinical leadership to ensure that health-care services are coordinated seamlessly. Here, Jackie discusses her advocacy for equitable care for LGBTQIA communities, and ways nurses can provide culturally congruent care.

A nurse and mother writes anonymously about her transgender child, and describes her feelings through the multi-layered coming out process. The parental dreams for her child that were based on societal norms, changed to reflect the goals and dreams of her transgender child. While the LGBTQ community has had wide acceptance nationwide, there still is work to be done where discrimination still occurs in several states.