VNSNY Provides Specialized Post-Op Care for Gender Affirmation Patients
Since the spring of 2016, VNSNY has cared for close to 100 patients who have had gender affirmation surgery
One of the first issues VNSNY nurse Soraya Gomez faced with her new patient, Roberta*, didn’t involve medical care, but it was still vitally important. Roberta had just come home following gender affirmation surgery (GAS), in which her sexual organs were transformed from a man’s to those of a woman. But her mother, who she was staying with during her recovery, continued to call her daughter by her former male name.
Drawing on the GAS training she had received at VNSNY, Soraya stepped in politely but firmly. “I pulled the mother aside and tried to explain in a nice way that it would be good if she addressed her child as she wished to be addressed,” she says. “Traveling from one gender to another is a big change, and patients going through it really need to have their feelings supported.”
Over the next several weeks, in addition to providing emotional support, Soraya monitored Roberta’s overall recovery, coached her through the vaginal dilation process—something that needs to be done several times a day following male-to-female surgery, to prevent closure of the newly fashioned vagina—and kept Roberta’s surgeon, Dr. Jess Ting, and the rest of Roberta’s medical team at Mount Sinai–Beth Israel Hospital in Lower Manhattan updated on the patient’s progress. “Roberta told me she didn’t realize that there were professionals like me,” she adds, “who understand transgender surgery and will come to people’s homes to take care of them.”
To date, VNSNY has trained 108 VNSNY clinicians in the post-acute care of GAS patients. While this group consists mostly of nurses like Soraya, it includes a growing number of rehabilitation therapists as well. The training program, which began in March 2016—the same time Mount Sinai–Beth Israel launched its GAS practice—is directed by Shannon Whittington, an Interdisciplinary Care Team Manager with VNSNY Home Care. The program includes a cultural sensitivity component and a clinical component, in which the clinicians learn how to support the patient’s surgical recovery.
“The clinical aspect of the training is obviously very important,” notes Shannon, “but we also really stress the cultural side. This population is accustomed to being discriminated against by healthcare workers. When our clinicians ask patients what their preferred pronoun is, for example—some people prefer ‘he’ or ‘she,’ while others may prefer to be called ‘they’—the patient understands right away that our caregivers know what they’re doing.”
Since the spring of 2016, VNSNY’s GAS team has provided post-surgical care for close to 100 patients. While about 70 percent have been referred by the surgeons at Mount Sinai–Beth Israel, VNSNY also takes GAS referrals from NYU Langone Medical Center and the Rumer clinic in Philadelphia. Home care episodes typically last three to eight weeks. Each patient receives several home nursing visits per week at the start of care, with the schedule then tapering off as recovery progresses.
“Our collaboration with VNSNY has been fantastic from the get-go,” says Zil Goldstein, Program Director for the Center for Transgender Medicine and Surgery at Mount Sinai. “Implementing this special training around the GAS process has been a smooth operation, and we’ve had some great outcomes right from the start—patients being very happy, and feeling they’re really being taken care of after they go home. Post-operative care is a critically important part of the GAS clinical process, and there’s a huge emotional element involved as well. For our patients, having someone available who has been trained in this area to come in regularly and make sure they’re okay is incredibly reassuring.”
* The patient’s name has been changed for privacy.
The Take-Away: Over 100 nurses and other clinicians with VNSNY Home Care are now providing specialized home care services to patients who have just undergone gender reassignment surgery.
