Gender-Affirming Care Seen as Compassionate Care at VNS

Shannon Whittington, VNS Health Clinical Director of the Gender Affirmation Program (GAP) and Asia Lyons, VNS Health GAP Social Worker

VNS health’s gender affirmation program shows the power of compassionate health care

By Shannon Whittington, DNP, MSN, RN, CCM, Clinical Director of the Gender Affirmation Program (GAP) at VNS Health

HEALTH - For some of us, we likely put little thought into whether a healthcare professional respects our gender identity. But as many nonbinary and trans patients have found, just filling out a form or introducing themselves can be a fraught experience. Will the provider respect and honor their identity? Will they be empathetic to their experience?

Whatever your gender identity is, the truth is that everyone deserves compassionate, informed health care. Unfortunately, there is a dearth in care for nonbinary and transgender patients who receive gender affirmation surgery across the U.S., and many are recuperating alone at home, often with little or no support. 

PRIDE month is a reminder of not just the importance of celebrating the rainbow of sexuality and gender identity, but for those of us in healthcare, it is a time to remember how important patient-centered care is in helping our patients stay healthy inside and out.

To address this need, the VNS Health Gender Affirmation Program (GAP) has worked to address the unique needs of transgender and nonbinary people having gender affirmation surgery, providing post-operative care that respects and honors the unique needs of these patients.

Recovering fully at home after gender affirmation surgery can make a world of difference, as patients can feel comfortable and safe in their own space. Before going home, a VNS Health intake team member will assess their needs and ensure a safe transition home, create a personal care plan for the most comfortable recovery possible, and get approval for home care services through insurance.

As one past patient said, “I did have a few concerns about a nurse coming into my home because I didn’t want anyone to see me at my lowest point. But everyone was so gentle and caring, and made sure that my needs were met. The nurse that came to visit me, felt like talking to an old friend. Overall, it was a great experience and I really felt heard.”

After gender affirmation surgery and throughout the recovery period, a VNS Health nurse will:

• Manage after surgery care and follow-up appointments.

• Provide skilled nursing services (such as dilation support, emptying drains, and changing bandages).

• Promote good self-care habits to help with anxiety, dysphoria, or depression.

• Assess and address mental health needs.

Since the spring of 2016, VNSNY has trained more than 400 clinicians in caring for GAP patients, and those clinicians include nurses, rehabilitation therapists, home health aides and social workers. The training program covers a cultural sensitivity component and a clinical component, in which the clinicians learn how to support the patient’s surgical recovery.

Kelley Henry, a nurse with VNS Health’s GAP program, stressed the importance of providing emotional support after surgery. “Once we meet and get to know each other, my patients tend to lean on me. It’s extra care beyond the medical aspect. There’s an emotional aspect as well,” Henry said. “A lot of our patients have no support from family or friends, and therefore they have feelings of depression or anxiety, and they just want somebody to hold their hand through it. And because of our training, that’s exactly what we do.”

A past GAP patient said that they especially appreciated the support and advocacy from their nurse. “This program was the biggest help I had in terms of aftercare. A lot of times if I was having issues that I didn’t think were so serious, my nurse was there to tell me ‘No, your health comes first, this is what you need to do, this is important. If you don’t say something, I’m going to say something,’ And that alone has saved me multiple times.”

For VNS Health RN Debbie Starace, her GAP training helped her meet both the physical and emotional needs of her patients. “It’s an intimate relationship because as a nurse, what we’re doing is addressing their sexuality. It's an honor to be able to help them get through their journey, and I can learn something from every single one of the patients,” said Starace. “Each person really can teach us more about humanity. And I think if we all could open our eyes to that, we live in a better world.”

The VNS Health Gender Affirmation Program also has a full-time social worker of trans experience, Asia Lyons, who has been serving the LGBTQ+ community for more than a decade. Lyons works closely with GAP patients as a social work care coordinator to help them through the entire process. When Lyons first calls her patients to introduce herself, she tells them right away that she is a trans woman, which she finds often helps ease many of the fears they might have when working with a new clinician. The opportunity for patients to speak with someone who understands their lived experience provides a personal level of insight that is impossible to replicate.

One of our patients said that the empathy and understanding from those in the program impacted not only their health but also in feeling more accepted. “A lot of people don’t understand that one little thing like even handing someone a tissue when they’re crying can change their whole experience.”

For more information about our services, or to refer a patient to the VNS Health Gender Affirmation Program, please call at 1-866-632-2557.