How To Treat Transgender Patients With Sensitivity
With society becoming increasing more accepting of transgender people, a growing number of physicians are finding they are unsure of how to treat these members of society with sensitivity. Besides doctors, there is also a lack of understanding amongst support staff in medical practices on how to respectfully treat transgender patients. Many healthcare workers are uncomfortable and awkward around these patients. Once a long-term patient-provider relationship has been established, some of the awkwardness disappears, but a better understanding of the issues can help put both patients and providers at ease from the very beginning.
Emergency room physicians deal with situations that are oftentimes life-threatening. There is no special training imparted to these clinicians on how to care for LGBTQ and transgender patients. This can sometimes delay care and adversely affect the patient’s health.
At the annual conference of the American College of Emergency Physicians, Dr. Ann Daul offered some guidance in this regard. She presented a chart with suggestions for appropriate language that healthcare providers can use when communicating with transgender patients. This is applicable not only to emergency physicians, but to providers from all specialties.
How to address transgender patients
The use of more neutral terminology such as spouse, parent, and partner is preferable instead of husband/wife, mother/father, and boyfriend/girlfriend. If a healthcare provider is unsure of how to address a patient (he or she), they should simply ask. What is your gender identity, how do you like to be addressed, what pronoun do you prefer, or what gender were you assigned at birth, are all appropriate questions, suggests Daul.
When the chest or genital area of a transgender patient needs to be examined, this calls for particular sensitivity. A transgender patient’s sexual identity is oftentimes in conflict with their genitals. A patient who identifies as a male may not have undergone gender reassignment surgery and may still have breasts and female genitalia. In such cases, the patient still needs a breast examination, a Pap smear, and other preventive or screening female examinations, but may feel uncomfortable going to an OB/GYN office. Similarly, a patient who identifies as a female may balk at the suggestion of a screening prostate exam.
Transgender patients are more vulnerable
Healthcare providers need to address these health issues in a professional manner that puts the patient at ease. Many transgender patients put their health at risk simply to avoid the awkwardness of medical testing. What is even more unfortunate, however, is that according to a report by the National Gay and Lesbian Taskforce and the National Center for Transgender Equality, close to 20 percent of these patients are denied care or access to medical attention.
The Affordable Care Act is aimed at reducing disparities in healthcare for the most vulnerable Americans. The final rule of the Act came into effect on October 16, 2016. With the implementation of Section 1557, the Act specifically prohibits discrimination or denial of healthcare to any individual based on gender stereotypes or gender identity. The rule also requires that healthcare providers and health programs treat every individual according to their gender identity.
Under the final rule of the ACA, every practice is required to post notices informing patients about the discrimination policy, including discrimination based on gender. Practices must also meet other requirements such as language access. As part of compliance with Section 1557, a practice must educate and train staff on how to make all patients, including transgender patients, feel welcome and comfortable at the medical clinic.
Treating transgender patients with sensitivity is not only the right thing to do, but also important to protect a practice from legal complications. If a healthcare practice fails to comply with these rules, a patient can bring a lawsuit against the practice and seek compensation related to discrimination. Medical practices can avoid this by training their staff and adopting a non-discriminatory culture towards all patients, including transgender patients.