Chapter 6: Care of LGBTQ+ & Gender Diverse Patients

The minority stress model serves as a theoretical framework for understanding how chronic exposure to prejudice and discrimination creates adverse health outcomes in LGBTQ+ populations. Nurses learn evidence-based communication strategies for conducting affirming health assessments, including appropriate use of chosen names and pronouns, avoiding assumptions about relationships and family structures, and creating inclusive clinical environments through visual cues and policy implementation. The chapter thoroughly explores health disparities disproportionately affecting LGBTQ+ individuals, including elevated rates of mental health disorders, substance use, intimate partner violence, HIV, sexually transmitted infections, and barriers to preventive care. Special attention addresses the unique needs of LGBTQ+ youth who experience higher rates of depression and suicidal ideation, and older adults who face isolation and discrimination in healthcare settings. Clinical care components include preventive health measures such as hepatitis vaccinations for men who have sex with men, HIV pre-exposure and post-exposure prophylaxis protocols, and cancer screening adaptations based on anatomy rather than gender identity. The chapter provides comprehensive coverage of gender-affirming interventions, including hormone therapy administration, perioperative care for gender-affirming surgeries such as chest reconstruction and genital surgeries, fertility preservation counseling, and long-term health monitoring. Ethical considerations encompass advance directive planning and patient autonomy protection, while legal aspects address healthcare decision-making rights and non-discrimination policies.