For one Swedish nurse, an advanced degree provides an opportunity to expand LGBTQIA+ care

October 6, 2022

Swedish Communications

With a Doctorate in the Practice of Nursing, Swedish Orthopedic Institute RN Cy Soliman will focus on gender-affirming care.

I‘ve been a Registered Nurse at the Swedish Orthopedic Institute since 2016. A couple a years ago I made the decision to go back to school for my Doctorate in the Practice of Nursing (DNP) because I want to expand the focus on my nursing practice as a family nurse practitioner concentrating on gender affirming care.

As part of my degree program at Seattle Pacific University, I’m required to complete a final project in my area of study. I was thrilled when Swedish agreed to take me on as I was looking for a facility to complete my DNP project. Knowing that I want to focus my work on LGBTQIA+ care, I was introduced to Peter Mann-King, the manager for Swedish’s LGBTQIA+ program, and Kevin Wang, M.D., the program’s medical director. As a nurse working for Swedish, I was excited to partner with the same organization for my doctoral project.

Since Seattle is one of the most gender-diverse cities in the country, it is essential to have adequate healthcare access for the LGBTQIA+ community. One of the significant aspects of gender-affirming care is hormone replacement therapy (HRT). It is a safe way to help transgender and nonbinary individuals transition to exhibit the physical features of their desired gender identity. However, many primary care providers (PCPs) are reluctant to prescribe HRT due to a lack of education and training. Since some clinicians voiced the need and interest in being LGBTQIA+ champions in their respective clinics, educational sessions were created to support them.

Although there is more work to be done in ensuring equitable healthcare access for the LGBTQIA+ population, the continuous education, and growth surrounding diversity and inclusivity is a step toward Swedish’s mission to “improving the health and well-being of each person it serves.”

I was fortunate to focus my project on this need and discuss the cultural and clinical competence of PCPs in gender-affirming care. It specifically discussed transfeminine, transmasculine, and nonbinary hormone replacement therapy. We utilized the Project Extension for Community Health Outcomes (ECHO) model, which provided a framework for delivering this project. It is designed to provide a low-cost solution to give primary care clinicians the education to provide specialty care access to all. The virtual setting was the perfect scenario given the struggles with the COVID-19 pandemic.

With Dr. Wang’s leadership, we successfully piloted the first cohort of 12 primary care providers. My role was to evaluate the results of this project, which showed promising results. I hope this would provide the groundwork for future cohorts receiving HRT education and foster a culture change within the organization by removing the stigma surrounding HRT.

Although there is more work to be done in ensuring equitable healthcare access for the LGBTQIA+ population, the continuous education, and growth surrounding diversity and inclusivity is a step toward Swedish’s mission to “improving the health and well-being of each person it serves.” More importantly, I hope it would increase healthcare access for the transgender and nonbinary community and have Swedish be a destination for safe, gender-affirming care.

Cy Soliman (she/her) has been a nurse at Swedish Orthopedic Institute since 2016. She is pursuing her Doctor of Nursing Practice degree at Seattle Pacific University to become a family nurse practitioner and hopes to focus on gender-affirming care. When not wearing her nurse hat, she loves to spend time with her family traveling, playing board games, and indulging in good food.

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