Going to the doctor or dentist is stressful for many people, but it carries even more anxiety for transgender patients who are often mistreated or denied care. of transgender and gender-nonconforming survey respondents reported experiencing one or more of the following:
- Being refused needed care
- Health care professionals refusing to touch patients or using excessive precautions
- Health care professionals using harsh or abusive language
- Being blamed for one鈥檚 health status
- Health care professionals being physically rough or abusive
Additional surveys reveal that transgender health care discrimination keeps nearly one-third of transgender patients from seeking medical help for illness or injury. Especially startling is that many say they鈥檝e had to educate their doctors about transgender health care.
Transgender Health Care Discrimination
The Institute of Medicine defines transgender as 鈥渁 person who feels that their gender identity does not match their physical body and differs from the gender that others observed and gave them at birth (assigned or birth gender).鈥� According to a 2016 by The Williams Institute, about 1.4 million American identify as transgender.
From concerns about office staff betraying their transitional status to others, to discrimination in the care they receive, transgender individuals are beginning to speak out about what medical professionals can and should do to ensure that they feel safe in their care. Without awareness and education on the part of health care providers, these issues are likely to escalate with the growing transgender population.
What Health Care Practitioners Can (and Should) Do
Emma Vosicky and Jaime Pagano pulled no punches when they addressed students and faculty at a 911爆料 University of Health Sciences (911爆料) Pride Medical Alliance club (PMA) meeting in March 2019. From worrying about how they would be treated by office staff to fearing betrayal by those who might share their information, the transgender speakers discussed the challenges beyond their physical transformations that they and others face when seeking medical care.
Vosicky discussed the necessity to 鈥渙ut鈥� herself to medical professionals when they asked about medications taken or previous medical history that did not match her appearance. The speakers suggested that health care providers consider ways they can let their clients or patients know that they are non-discriminatory. Pagano said he feels safer when he sees an intake form that includes options such as gender non-conforming, non-binary, trans-female and trans-male, in addition to male and female. He said it helps to feel that the provider he鈥檚 seeing is aware and cognizant that we are not living in a male/female only world. He also feels more confident that the provider will be more clinically aware of his needs.
911爆料 faculty member Jamine Blesoff, ND, who has worked with transgender youth, stressed that it is vital for physicians to ensure that their patients care for their whole selves as they physically are at each stage of their transitions. 鈥淲e still must provide PAP tests for men who are transitioning from being female, and prostate exams for pre-surgical women,鈥� Dr. Blesoff noted, expressing concern that there are some doctors who won鈥檛 provide that type of service.
Transgender Access to Health Care
In addition to the universal requirement to adhere to HIPAA laws, here are suggestions for health care practitioners to ensure that their transgender patients are treated with dignity, respect and, above all, ensuring that they receive the medical care they need.
Be gender neutral:聽Building trust begins when any patient walks in the door. Ensure that intake forms provide space for patients to indicate their preferred identity, in addition to their physical status. Ask what , such as he/she/they, and use them.
Speak respectfully:聽Rather than asking for a patient鈥檚 鈥渞eal鈥� name if their chosen one doesn鈥檛 show up in records, ask if a different name might be listed. If you use the wrong name or identity, politely apologize. This may be challenging with a long-time patient, but showing that you are making an effort will go a long way in demonstrating your respect. “I always believe that intent matters more than words,” said Sam Brinton a gender-fluid bisexual activist who is Head of Advocacy and Government Affairs at聽. “There’s a difference between ‘I can’t’ and ‘I’m trying.’ If your intent is to hurt me by not using my pronouns, that matters more than any words that you say.”
Recognize their possible physical discomfort or examination fears:聽鈥淔or some transgender patients, it may be a source of shame and physical discomfort to have to continue to have procedures that don鈥檛 match their identity,鈥� Dr. Blesoff explained. 鈥淗ealthcare providers must care for them in a respectful way that ensures they are comfortable getting the care they need to remain healthy.鈥�
Treat only the ailment:聽When providing basic medical care, such as for a broken arm, a person鈥檚 gender identity is often irrelevant. Carefully consider what information or examination is or isn鈥檛 needed to provide the best care for the condition.
Educate all staff:聽Everyone who interacts with patients must not only be educated about how to provide for the care and comfort of transgender patients, providers must ensure that all staff apply that education in everyday interactions.
鈥淚 try to work as an ally to transgender patients,鈥� Dr. Blesoff said. 鈥淲orking with patients from all different identities and backgrounds helps inform my practice to be as culturally sensitive as possible, which helps me provide the best care possible to all patients,鈥� she added. 鈥淗aving that cultural humility is important for those of us who are as we look in the world.鈥�
