Accommodating and caring for transgender residents is a new—but important—endeavor for many organizations. “We are still learning, and don’t know a lot yet,” said Angie Szumlinski, LNHA, RN, GERO-BC, RAC-CT, director of risk management for Chelsea Rhone, LLC.

This “learning” is coming from many sources. For one, the 2023 Long Term Care Index, the first validated survey of LGBTQ inclusion in this care setting, identified some benchmarking measures. These include non-discrimination policies and staff training, resident services and supports, employee benefits and policies, and resident and community engagement. The survey offered some promising news: 90 percent of participants say they have updated their resident and employee non-discrimination policies to include protections based on both sexual orientation and gender identity; and 54 percent say they collect data on gender identity to inform their policies and practices.

Communities can start with a review of their current materials and practices. These should include “sexual orientation, gender identity, or expression” as a protected class or include them in the definition of “sex” in non-discrimination and dress code policies, the employee handbook, and employee training materials.

Szumlinski noted, “We need to look at how our training is done and approach policies and procedures in a way that is respectful of all staff and residents. It is important to know both federal and state laws regarding discrimination,” she said.

If your state has laws prohibiting discrimination on the basis of sexual orientation and gender identity, you cannot deny admission to a resident because they are transgender, and staff, including nurses and CNAs, may not refuse to provide treatment or care to a transgender resident. You must allow transgender residents to live in a room that is designed for the sex that matches their gender identity, and you may not segregate transgender residents from others in the building. Similar rights must be afforded to staff who are transgender.