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Transsexual individuals present to the emergency department for various reasons; yet, providers and nurses are often unaware of the unique needs of transsexual patients. This article provides an understanding of challenges faced by transsexual individuals in health care access and treatment. The authors explain commonly used terminology and provide an overview of the transition process including the Diagnostic and Statistical Manual, 4th edition criteria for diagnosis and the World Professional Association of Transgender Health's Standards of Care for treatment. The authors provide important details and specific recommendations for the culturally sensitive care of transsexual patients including using the correct name and pronoun, eliminating bias and discrimination, asking appropriate questions, implementing trans-inclusive policies and guidelines, and proper record keeping.