Abstract
In this article, we present a case study that illustrates the nurse's obligation in applying clinical judgment in determining the applicability and appropriateness of carrying out a standing order, and how nurses can navigate institutional policies that reinforce a gender binary and heteronormative ideals of womanhood while depriving the client of their autonomy. The case study also reveals some of the challenges transgender, nonbinary, and other gender expansive people may experience when health care institutions have standing orders that are not inclusive of all gender identities.