Discuss communication between a nurse and a transgender patient attempting to transition from male to female. 2. Present utilization of therapeutic communication for assigned scenarios. a. Discuss why communication is imperative in this situation. b. Give specific examples of various therapeutic communication techniques to utilize with the family and patient.. c. Review the case study and present an example of inappropriate versus appropriate communication with the patient and family. 3. Allow time for questions. 4. Include references from at least two nursing or medical journals or reference sources. 5. All PowerPoint Presentations and Reference Pages must be emailed to the instructor prior to presenting in class. Scenario: Natalie was born a biological male and registered as male on her birth certificate. She began to experiment openly with her dress, body language and voice. She referred to herself and requested that others call her "Natalie." She remained depressed and discouraged, upset about the growing distance in her family. Some family members could not understand her behavior. Others reacted with disgust or hostility. Natalie moved away from her hometown, keeping very little contact with family and friends. Natalie desired to change the appearance of her body. "I want to look more like a woman." She visited her doctor to learn more about medical treatment. Her doctor was uncomfortable being involved in her care. He quickly referred Natalie to psychotherapeutic care, her problem being "mental not physical." Natalie visited a psychotherapist and learned that diagnosis with a mental disorder is a precondition for hormone and surgical treatment. Natalie's transition has been difficult. She suffers from verbal abuse and harassment and fears violent attacks. Once she completed the diagnostic phase, Natalie was referred for hormone treatment. She learned, however, that this treatment was excluded from health insurance coverage. When Natalie called to inquire about the exclusion, a claims manager informed her that: "We only cover medically necessary treatment. Hormonal and surgical treatments do not qualify. There is no medical evidence they cure the mental disorder. You are lucky to have the diagnosis. With that, we will cover more psychotherapy." Distraught with this news and feelings of helplessness Natalie attempts suicide and has been brought to the ER.