A psychiatric-mental health nurse practitioner is employed on an acute inpatient psychiatric unit for adolescents. He is evaluating a 17-year-old client who presents as male-to-female transgender. The client wishes to be called "Christine" and uses "she/her" for pronouns. She wants to know how if her female name is being used in her chart. How should the PMHNP respond?

"I sympathize with your situation, but you have to realize that as a teenager you cannot possibly truly be transgender."

"I am using your female name on all my clinical notes. Documented names and genders are only needed for legal items such as consents or prescriptions."

"It doesn't matter what is in the notes as long as I and other members of the clinical team address you properly."

"Insurance might not pay for your care if the notes do not match your legal name on your insurance card."