Diversity And Health Assessments
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining.
Sample Solution
John’s socioeconomic factors include being unemployed and living with his parents. Additionally, he has been obtaining testosterone from the internet to give to himself, which puts him at risk for infection or complications due to unreliable hormone sources.His spiritual lifestyle factor involves smoking marijuana, although it is medically approved in his state. He also has depression episodes and HIV positive status but remains virally suppressed.
When interacting with John it is important to be sensitive to his cultural background as an individual who identifies as male even though their natal sex was female. This includes using non-binary language when asking questions about gender identity and speaking respectfully about topics related to transitioning. It is also important not to assume anything about John’s sexual orientation, since this does not always correspond with gender identity. Additionally, when discussing John’s medical condition it may necessary for providers and healthcare staff to use medical terminology that reflects both genders in order to gain a complete understanding of the patient’s health history while meeting their needs in terms of respectful language usage when discussing their gender identity or transition journey.
Questions targeted towards gaining a comprehensive health history include:
1) When did you first begin your transition process?
2) Are you currently taking any medications or supplements? How long have you been taking them?
3) Have you experienced any significant mental health issues such as depression or anxiety during the past year? If so, how have they affected your daily life?
4) What type of support system do you have available now that you are living back home with your parents?
5) Are there any aspects of your current lifestyle that could put you at risk for decline in physical health (i.e., smoking cigarettes/marijuana)?