Trans and gender diverse people often report encountering many barriers to care when seeking health care services. According to researchers, some of these barriers include trans and gender diverse people being uninsured/underinsured, patients having to teach their providers about transgender health, experiencing transphobic discrimination during healthcare visits, and a general lack of healthcare providers knowledgeable about transgender health (Safer et al., 2016; Warner & Mehta, 2021). Citing the 2015 United States Transgender Survey, Warner & Mehta write that “Among the conclusions provided, 33% of respondents seen by a healthcare provider within the year prior to completing the survey reported having at least one negative experience related to their gender identity” (Warner & Mehta, 2021, pg. 3359).
Providing a safe and nonjudgmental healthcare environment is necessary when interacting with any patient. Many trans and gender diverse people report that many of the solutions are relatively simple and will improve the quality of care for everyone. In an effort to continue the discussion on supporting the trans community, particularly in healthcare settings, this article will serve as a follow-up post to our recent article International Transgender Day of Visibility, and provides tips on how to interact with trans and gender diverse patients.
Tips:
- Use a patient’s personal name and pronouns: A simple way to make trans and gender diverse patients comfortable is by using their personal name and pronouns. If you are unsure of how to refer to your patients, ask what their pronouns are and how they would like to be referred to. You can also offer your name and pronouns first and offer them the opportunity to share their information. In an article in Healthline, KB Brookins also suggests providers evaluate their intake forms and include information fields such as “Legal name for insurance, chosen name/nickname, sex assigned at birth (if necessary), sex listed on insurance, pronouns, gender identity, sexual orientation (if necessary)” (Brookins, 2022). Consider leaving open fields for people to write in their responses instead of checking off a set number of boxes. Using a person’s correct pronouns and name will build trust between patients and providers and this will encourage patients to return for future appointments.
- Do not ask personal questions not related to care: Trans and gender diverse people are subjected to frequent and invasive questioning about their bodies or any medical procedures they may have experienced. This form of questioning is deeply personal and can make trans and gender diverse people uncomfortable. Vermeir, Jackson & Marshall write “Many trans people encounter HCPs [healthcare providers] who ask inappropriate questions regarding their trans identity or bodies, or questions that are irrelevant to their care” (Vermeir, Jackson & Marshall, 2018, pg. 16). To avoid these uncomfortable situations, Vermeir et al. suggests that providers maintain professional boundaries and ask questions that are directly related to the reasons behind a patient’s current visit. “Participants recommended that HCPs remember that a patient’s purpose is not to satisfy one’s interest, and that even if a question is relevant to one’s care, it must be asked with sensitivity and appropriateness” (Vermeir, Jackson & Marshall, 2018, pg. 16).
- Learn more about the community from multiple perspectives: Understanding the transgender community allows providers to better understand their patients’ needs and provide a high standard of care. It may seem easy to ask your patients about the history and current state of the transgender community, but some trans and gender diverse people report that they feel burdened when placed in this position. There are organizations, novels, memoirs, historical accounts, and other resources that may serve as appropriate sources of information. Resources will be listed in the ‘Reference’ section. Here is a brief selection of titles:
- John Hopkins Center for Transgender and Gender Expansive Health offers healthcare services to transgender youth and adults. Their ‘Clinician Resources’ section also offers “a variety of clinical resources from Johns Hopkins and beyond to help you provide high-quality care to patients” (John Hopkins University, 2023). These resources are an excellent way to learn from other clinicians and providers.
- If you’re interested in reading narratives and autobiographical accounts from trans and gender diverse people, check out titles such as Sorted: Growing Up, Coming Out, and Finding My Place by Jackson Bird, Gender Queer by Maia Kobabe, All Boys Aren’t Blue by George M. Johnson. (Please note some of these titles may require a request through Himmelfarb’s Documents2Go or Consortium Loan Service). For more recommendations, check out articles from Them.us or this list from Book Riot.
- As mentioned in our previous articles ‘International Transgender Day of Visibility: How to Support the Transgender Community’ and ‘International Transgender Day of Visibility, and How You Can Support’, Himmelfarb Library has plenty of resources on transgender healthcare. Visit our Diversity and Disparities in Health Care collection for titles such as Health and Wellbeing in Sexual Orientation and Gender Identity, Comprehensive Care of the Transgender Patient, and more.
These tips are just a starting point for treating transgender and gender diverse patients with respect and dignity. Vermeir, Jackson & Marshall also suggest that educational organizations broaden the scope of their curriculums to include transgender health and healthcare. The authors say “...we believe that there is also a need for education organizations and regulatory bodies to incorporate this topic into their curriculums and continuing education opportunities to promote HCPs’ cultural competence including an acknowledgment of the power differentials between HCPs and trans patients” (Vermeir, Jackson & Marshall, 2018, pg. 15). Ultimately, healthcare providers must listen to transgender and gender diverse patients and unlearn any biases they may have about the transgender community. By incorporating these and other tips into your practice, you will build trust with your trans and gender diverse patients making it easier to meet their healthcare needs.
References:
- Brookins, KB. (2022, July 28). How Medical Professionals Can Create Trans-Positive Environments. Healthline. Accessed April 7, 2023 from https://www.healthline.com/health/how-medical-professionals-can-create-trans-positive-environments
- Centers for Disease Control and Prevention. (n.d.). Patient-Centered Care for Transgender People: Recommended Practices for Health Care Settings. Retrieved April 7, 2023 from https://www.cdc.gov/hiv/clinicians/transforming-health/health-care-providers/affirmative-care.html
- Human Rights Campaign Foundation. (n.d.). Transgender Patient Services & Support: Resources for Providers and Hospital Administrators. Retrieved April 7, 2023 from https://www.thehrcfoundation.org/professional-resources/transgender-patient-services-support-resources-for-providers-and-hospital-administrators
- Johns Hopkins University. (2023). Clinician Resources. Center for Transgender and Gender Expansive Health. Retrieved April 7, 2023 from https://www.hopkinsmedicine.org/center-transgender-health/clinician-resources.html
- Safer, J.D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., Sverlius, J. (2016). Barriers to Health Care for Transgender Individuals. Current Opinion in Endocrinology, Diabetes, and Obesity, 23(2), 168-171. https://doi.org/10.1097/MED.0000000000000227
- Vermeir, E., Jackson, L.A. & Marshall, E.G. (2018). Improving Healthcare Providers’ Interactions with Trans Patients: Recommendations to Promote Cultural Competence. Healthcare Policy, 14(1), 11-18. https://doi.org/10.12927/hcpol.2018.25552
- Warner, D.M. & Mehta, A.H. (2021). Identifying and Addressing Barriers to Transgender Healthcare: Where We Are and What We Need to Do About It. Journal of General Internal Medicine, 36(11), 3559-3561. https://doi.org/10.1007/s11606-021-07001-2
