NRP 563 DQ 2

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Nurse practitioners can make many small changes to signal respect andaffirmation to LGBTQIA+ patients. Some examples include communicatingnon-discrimination policies to all employees and patients on hospitalwebsites, posted in patient waiting areas, and on patient registration forms,displaying rainbow decals or wearing lapel pins; may say "safe space" or "allare welcome," and add "partnered" to demographic forms.Some sexual health considerations based on age or cultural influences aredropping hormone levels, leading to changes in sexual organs, decreases insexual function and sexual response, mental health status such as anxietyand depression, and aging causes changes in body image and a loss ofattractiveness. Age and senescence lead to the decline of hormone levels,which affect the changes in sexual organs and sexual functions of olderadults, thus affecting sexual desire and sexual experience. Eleven of theincluded literature mentioned the influence of physiological factors on thesexual life of older adults, as reported by researchers. There is less mucussecretion, weak ejaculation, and less semen secretion before ejaculationwhen men's sexual desire declines and erections require more stimulationand last less time. The refractory period lasts for a long time. Increasedsexual arousal, decreased vaginal lubrication, vaginal mucosa thinning, andpainful sexual intercourse require more time in women, as does lessfrequency and intensity of orgasm.Nurse practitioners must actively implement changes that signal respect and affirmation toLGBTQIA+ patients. Communicating non-discrimination policies to all employees and patientsthrough hospital websites, signage in patient waiting areas, and clear statements on patientregistration forms is essential. Additionally, displaying rainbow decals or wearing lapel pins thatstate "safe space" or "all are welcome" is crucial in fostering an inclusive environment. It is alsoimperative to include "partnered" in demographic forms to accurately reflect the diversity ofrelationships. (Fitzgerald Health Education Associates, 2025). When addressing the sexual healthof older adults, we must recognize the significant factors influenced by age and culturalbackgrounds. Declining hormone levels are critical as they lead to changes in sexual organs andadversely affect sexual function and response. Mental health challenges, including anxiety anddepression, are common, and aging can severely impact body image and perceptions of

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attractiveness. Research confirms that age-related declines in hormone levels directly impact thesexual desire and experiences of older adults. Eleven studies have documented the physiologicalfactors that affect the sexual lives of older adults. Men often experience reduced mucusproduction, weaker ejaculation, and decreased semen production, which leads to a decline insexual desire and necessitates increased stimulation for erections that last for shorter periods.Additionally, the refractory period significantly lengthens. For women, increased sexual arousalcan coincide with reduced vaginal lubrication, thinning of the vaginal mucosa, and painfulintercourse. These changes demand more time and effort for satisfying sexual experiences, alongwith a noted decrease in the frequency and intensity of orgasms. It is critical to acknowledgethese challenges and address them with sensitivity and the appropriate resources (Zhang, 2023).Fitzgerald Health Education Associates. (2025). How NPs can create welcoming environmentsfor LGBTQIA+ patients, https://www.fhea.com/resource-center/how-nps-can-create-welcoming-environments-for-lgbtqia-patients/Zhang, F., Yang, Z., Li, X., & Wang, A. (2023). Factors influencing the quality of sexual life inolder adults: A scoping review. International journal of nursing sciences, 10(2), 167-173.https://doi.Org/10.1016/j.ijnss.2023.03.006Hi Leah, the diverse experiences reported by transgender and gender-expansive (TGE)individuals regarding pregnancy and transition carry significant mental health implications thatmust be addressed. While some individuals may find pregnancy enjoyable and report no negativeeffects from discontinuing testosterone, it is crucial to recognize that others face seriouschallenges. These challenges arise from hormonal fluctuations associated with tapering offtestosterone and the conflict between their gender identity and the experience of pregnancy.Furthermore, delaying medical transition due to concerns about potential impacts on future

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