Cultural Sensitivity and Challenges in Management of the Transgender Patient With End-Stage Renal Disease in Transplantation

The article from 2016 discusses the complexities of managing transgender patients with end-stage renal disease (ESRD) in the context of transplantation. It underscores the need for cultural sensitivity and comprehensive understanding of the healthcare needs specific to transgender individuals. The article points out the lack of provider knowledge and acceptance as a significant barrier to care and recommends accurate documentation of demographic information, healthcare records, chosen name, and gender identity. It also emphasizes the importance of considering the patient's health and medical history, surgical history, insurance coverage, physical examination, and psychological evaluation. The article notes the high rates of psychiatric comorbidities among transgender individuals and the potential psychiatric side effects of gender affirmation surgery and hormonal therapy. It stresses the need for a multidisciplinary approach to care, including mental health providers, to address the risks associated with hormone therapy and immunosuppression, such as new-onset diabetes after transplantation (NODAT) and venous thromboembolic disease. The article concludes that thorough evaluation, management, education, and cultural sensitivity are essential for achieving optimal outcomes for transgender patients with ESRD undergoing transplantation.