Nurse practitioners bring to the table a holistic approach when caring for their clients. This holistic approach allows for the formulation of comprehensive patient-centered care plans that take into account the client's environment, available resources, and the personal preferences and needs of the client.
In this case study presentation; patient: Christine Jones is a transgender client who recently moved to a small midwest town and is in need of primary care services along with continuation of hormone therapy to support full transitioning from male into a female anatomy. The Family nurse practitioner, using Madeleine M. Leininger’s Theory of Nursing: Cultural Care Diversity and Universality as a framework intertwined with core competencies of the Advance Practice Nurse and current Evidence Base Practice principles in the management of hormonal replacement therapies formulates a holistic healthcare plan individualized for this client. Pathophysiologic theories of gender dysphoria are presented. Diagnosis is made according to the DSM-5 criteria of marked difference between gender identify and assigned gender, persistent beyond six months, and causing clinically significant distress in the social, occupational, or any other functioning impairment. Evidence Based Practice guidelines in the initiation and management of hormonal therapy for transgender individuals are noted. Core competencies of Advance Practice Nursing as an expert clinician, coach, holistic provider and leader are evident by discussing the pathophysiology and etiology of gender dysphoria, formulating a comprehensive and holistic patient-centered care plan taking into account patient preferences and needs along with the available resources within the patient's community, family support, and other factors influencing the health and wellbeing of this client. Annotating how Advance Practice Nurses can influence healthcare policy in order to expand healthcare access to the lesbian, gay, bisexual, transgender, queer/questioning, population demonstrates the leadership ability of the Advance Practice Nurse.