Working with transgender clients: Learning from physicians and nurses to improve occupational therapy practice

Background. Gender identity disorder and the process of transitioning involve both mental and physical health, yet there is virtually no discussion of transgender health care in occupational therapy. Purpose. This study draws on interviews with primary-care nurses and physicians about their experience with transgender health care, extending the insights gleaned there to make suggestions for occupational therapy practice with this population. Method. Semi-structured interviews were conducted with 12 primary care nurses and 9 physicians who had clinical experience with lesbian, gay, and bisexual patients. Findings. Participants felt uncertain about transgender care, wanting more specialized knowledge. Collaborating with patients, acknowledging stigma, ensuring inclusive systems and procedures, navigating health care, and providing holistic care emerged as key elements for best practice. Advocacy was a crucial part of care provision. Implications. Suggestions are provided for therapists to ensure that space and interactions are welcoming to transgender clients as well as suggestions for occupational therapy intervention in the transitioning process.