{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T16:32:38Z","timestamp":1777998758675,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2010,7,29]],"date-time":"2010-07-29T00:00:00Z","timestamp":1280361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the American Academy of Nurse Practitioners"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:bold>Purpose:<\/jats:bold> Transsexual presentations in primary care stress mainstream health care physical resources, institutional organization, and the cultural flexibility of providers and interdisciplinary staff. This article describes the ethical landscape, examines gender identity culture, and considers gender reassignment physiology. Nurse practitioners are challenged to advocate for this population.<\/jats:p><jats:p> <jats:bold>Data sources:<\/jats:bold> Sources for the discussion derive from published institutional guidelines, institutional and civic policies, web\u2010based information in the public domain, and professional journal articles.<\/jats:p><jats:p> <jats:bold>Conclusions:<\/jats:bold> Advocacy for cultural sensitivity, institutional policy change,and professional integrity will determine healthcare quality for this population. Advocacy for cultural awareness and institutional change has begun in larger institutions and metropolitan areas, but is necessary across primary care settings.<\/jats:p><jats:p> <jats:bold>Implications for practice:<\/jats:bold> Caring for transsexuals requires knowledge of anatomical reassignments, hormonal therapy effects, and cultural sensitivities particular to the gender identity community. Healthcare screening and physical exam modifications for these presentations require forethought and appropriate adjustments.<\/jats:p>","DOI":"10.1111\/j.1745-7599.2010.00532.x","type":"journal-article","created":{"date-parts":[[2010,7,29]],"date-time":"2010-07-29T15:09:44Z","timestamp":1280416184000},"page":"403-408","source":"Crossref","is-referenced-by-count":13,"title":["Transsexual primary care"],"prefix":"10.1111","volume":"22","author":[{"given":"Christopher O.","family":"Jenner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,7,29]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Blue Cross Wisconsin. (2006).Gender reassignment surgery: Clinical UM guideline. Fond du Lac WI: Author. 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(2004).Transgender health and the law: Identifying and fighting health care discrimination. Retrieved March 3 2009 http:\/\/www.transgenderlawcenter.org\/pdf\/health_law_fact.pdf"},{"key":"e_1_2_5_16_1","article-title":"VA system issues memo on treating trans vets","author":"Jacobs E.","year":"2007","journal-title":"Transgender American Veterans Association."},{"key":"e_1_2_5_17_1","volume-title":"A provider's handbook on culturally competent care. 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