I WAS A SPECTACLE. A FREAK SHOW AT THE CIRCUS: A TRANSGENDER PERSON'S ED EXPERIENCE AND IMPLICATIONS FOR NURSING PRACTICE

For most people, the decision to visit an emergency department is straightforward. Some persons consider their health care insurance coverage or their ability to afford the visit. Others wonder if their chief complaint is truly an emergency or if the problem can wait until their primary care provider's office opens. Few worry about clinician competence or are concerned that they may be denied care; however, transgender persons contemplating an ED visit sometimes face these issues.(1) The scarcity of clinical providers adequately prepared to care for transgender persons is a major barrier to seeking care. In addition, some transgender people encounter denial of services, discrimination, harassment, and even violence in health care settings. The accumulation of barriers causes some transgender people to avoid seeking even routine and preventive care.(1) The implication of these barriers to care is profound. The lack of high-quality, equitable health care is directly associated with a high lifetime suicide rate in the transgender community. (2)The lifetime suicide attempt rate for transgender people is 41% to 60%, a startling percentage that is at least 10 times higher than the 4.6% rate of general population. 2 Acknowledging the health disparities and injustices that transgender people face when accessing health care, the federal government and The Joint Commission created national health priorities and hospital standards for safe patient care for the transgender community. These priorities and standards are noteworthy, especially considering the paucity of existing body of knowledge related to transgender health care, which has been identified as a research opportunity.(1-4) Moreover, researchers often report that their findings are pertinent to the entire lesbian, gay, bisexual, and transgender (LGBT) community when their studies are only relevant to lesbians and/or gay persons.