Sexual Identity

Every question here, with the answer

1. A client who was assigned male at birth tells the nurse she identifies as female and uses she/her pronouns. The client has male external physical characteristics. What should the nurse do?

   1. Use he/him pronouns in the chart because they match the client's anatomy.
   2. Ask the provider which pronouns to use.
   3. Consistently use she/her pronouns in conversation.
   4. Avoid pronouns and use only the client's last name.

   Answer: Consistently use she/her pronouns in conversation.

   The client should be recognized as the gender with which they identify, so the nurse consistently uses the client's preferred pronouns even if physical characteristics are male. Using pronouns based on anatomy, avoiding pronouns, or deferring to the provider does not respect the client's identity.

2. A client assigned female at birth has short hair, wears masculine clothing, and tells the nurse she identifies as a woman. How should the nurse understand this?

   1. The client is transgender.
   2. The client's sexual orientation can be determined from her appearance.
   3. The client has gender dysphoria.
   4. The client is gender nonconforming, which does not necessarily indicate gender identity.

   Answer: The client is gender nonconforming, which does not necessarily indicate gender identity.

   Gender nonconforming describes behaviors or appearances that do not match societal expectations of the sex assigned at birth; the person may be cisgender. It does not make the client transgender or mean she has dysphoria, and appearance does not reveal sexual orientation.

3. During an admission history, a client uses the word "transsexual" to describe themselves. When is it appropriate for the nurse to use this term?

   1. Whenever the client has had gender affirmation surgery.
   2. Only when the client has used it to identify themselves first.
   3. Never, because it is always offensive.
   4. For any client whose gender identity differs from their assigned sex.

   Answer: Only when the client has used it to identify themselves first.

   Transsexual is usually considered outdated and could be offensive, so it should be used only when the individual has used it to identify themselves first. It is not a general term for all transgender people or those who have had surgery.

4. A transgender man who was assigned female at birth tells the nurse he is attracted to women. How should the nurse understand his sexual orientation?

   1. He is heterosexual.
   2. He is questioning.
   3. His orientation cannot be described because he is transgender.
   4. He is lesbian.

   Answer: He is heterosexual.

   Gender identity and sexual orientation are separate, so a transgender man attracted to women is heterosexual. Calling him lesbian bases orientation on assigned sex, and transgender people can be heterosexual.

5. A nurse is caring for a teen who is exploring their gender identity during puberty. Which actions are supportive? Select all that apply.

   1. Use the teen's chosen name and pronouns.
   2. Tell the teen that these feelings are a phase that will pass after puberty.
   3. Educate the teen and family about their rights in health care and education.
   4. Offer information about support groups and LGBTQIA+ organizations.
   5. Provide opportunities for open communication and validate the teen's feelings.

   Answer: Use the teen's chosen name and pronouns., Educate the teen and family about their rights in health care and education., Offer information about support groups and LGBTQIA+ organizations., Provide opportunities for open communication and validate the teen's feelings.

   Supportive care includes using the chosen name and pronouns, open communication and validation, access to resources, and teaching about legal rights. Dismissing the feelings as a phase is judgmental and does not affirm the teen's identity.

6. A nurse is reviewing a client's history for findings consistent with gender dysphoria in an adult. Which findings fit? Select all that apply.

   1. Wanting to get rid of sex characteristics because of that mismatch
   2. Significant distress lasting two weeks
   3. Wishing to be treated as a gender different from the assigned sex
   4. A mismatch between expressed gender and sex characteristics
   5. Enjoying clothing typical of another gender, without distress

   Answer: Wanting to get rid of sex characteristics because of that mismatch, Wishing to be treated as a gender different from the assigned sex, A mismatch between expressed gender and sex characteristics

   Adult findings include a mismatch between expressed gender and sex characteristics, wishing to be treated as another gender, and wanting to get rid of sex characteristics. Distress must last six months, and gender-nonconforming expression without distress is not dysphoria.