A transgender patient expresses doubt about undergoing breast augmentation; what is the most appropriate nursing response?

• A. This is a serious decision; take time to decide.
• B. It sounds like you’re unsure; talk with your surgeon.
• C. Maybe you can express your feelings to your partner before the surgery.
• D. You should proceed with the surgery anyway.

Answer: (C)

When a patient expresses doubt, the primary goal is to support autonomy and help the patient explore concerns in a nonjudgmental way. The best nursing response validates the patient’s feelings and invites further discussion, showing that you’re there to help them make a decision that fits their values and life situation. Suggesting that the patient share thoughts with a partner before the surgery opens space for emotional and practical support, helps reveal personal or relationship factors that could influence the decision, and keeps the decision-making process voluntary and informed. This approach avoids pressuring the patient, while still offering a path to clearer thinking and support.

The other approaches either shift the burden or pressure the patient. Saying the decision is final and to proceed regardless discounts the patient’s doubts. Directing the patient to talk only with the surgeon bypasses the personal and social context that matters. Encouraging the patient to express feelings to a partner may also be valuable, but without acknowledging the doubt and offering patient-centered support, it risks closing down the patient’s own voice in the decision.