0:06
I think working in a clinic that specializes in transgender care,
we see a lot of people coming in and they talk about how they've
had a terrible experience at another medical professional.
They talk about having gone to a clinic and
having it be something where they really needed urgent medical care, but
they were afraid to get that care, or they felt ostracized.
Or they felt like they couldn't be honest with the doctor,
because the providers weren't affirming to their gender.
And getting medical care as a transgender person is actually quite different than
getting medical care as a cisgender person, but it shouldn't really be so.
It is different because doctors feel like treating somebody who is transgender or
gender-nonconforming makes it specialty care.
They think that if they've never met somebody who is trans or
gender-nonconforming, or if they haven't taken a special class,
that this kind of work is out of reach.
And I would argue that it's really not.
In the same way that doctors see diverse people of all different kinds
all the time, transgender and
gender-nonconforming people are just diverse people.
And we often have specific medical concerns and
needs and parts of our lives that may be involved in medical transition,
but none of those things necessarily preclude giving quality care.
Some of the things that doctors can do right now, today,
to improve their practice in terms of how they serve transgender and
gender-nonconforming people are to ask folks how they identify.
You can ask really open ended questions.
If it's an enormous project to try to transform all of your intake forms and
all of the questions that people ask, try training people just to say, hey,
we ask everybody this, what name do you like to be called, how do you identify,
what words do you want me to use about your body?
Just asking those simple open-ended questions can really give somebody
the feeling that they are welcome and how they identify as welcome in the clinic.
Also, educate yourself, participating in education like this.
If you learn something, try to tell other people about it.
Because something that transgender and gender-nonconforming people often face
is the need to educate all of their medical providers, and
this can really be a barrier to care.
People feel like, gosh, I want to go to the doctor and I want to be seen for
a cold and I don't want to have to talk about my entire life story
just to have good medical care.
But the doctor would open the chart and maybe see that hormones are on there, and
all of a sudden that becomes a part of the visit.
But if you educate yourself, if you think about trans and gender-nonconforming
people just as diverse individuals, whose medical needs are pretty much the same as
everybody else's, meaning that they differ person to person, and
then try to meet the person in front of you where they are at.
If they're coming in to get seen for a cold, see them for the cold.
Make sure that you're trying to the best of your ability
to affirm that person through name, through pronouns, through the words they
like to use about their bodies, and then move on to treating them for the cold.
And those are really fast ways that you can change your medical practice.
Things you can do over the course of time is to integrate into your electronic
medical records how somebody identifies in terms of pronoun and in terms of name.
Making sure that those are things that all of the providers,
including the front desk staff, are able to see as soon as they open the chart or
when they're checking somebody in.
I often talk with folks about the kind of disparities that the transgender and
gender-nonconforming community face as compared to the rest of the general
population.
And we see that there are much higher rates of suicidality, of depression,
of alcohol and other substance use, of bullying, of sexual assault.
We see that the risk factors around
like HIV infection are higher for trans individuals and
then especially for individuals who have intersecting identities.
So maybe somebody who's a person of color, who identifies as feminine,
that person is experiencing sexism, they're experiencing racism,
and they may be experiencing transphobia.
And as a result of all of those social pressures, and
the kind of place that those people might find themselves in their lives,
they're at disproportionately high risk for HIV infection.
4:28
So all of this is going on behind the scenes.
And so when somebody walks into your clinic,
if the front desk staff calls them by the name they don't use, or
the front desk staff uses the wrong pronoun for that individual, it's not so
much that that in of itself is an enormous terrible thing to have done.
But rather that that is a compounding factor to somebody's life that is already
potentially really traumatic, really triggering, really exhausting.
And so knowing that you don't want to be the straw that broke the camel's back.
And that you really want your patients to feel like,
when I come into the medical clinic, here I am safe, here I can be well.
Here I can actually do what I need to do to take care of myself,
to take of my body, and to take care of my mental health.
Something as simple as using the right pronoun and the right name, and
especially having that happen with the front-end medical staff can really
make that difference.
Rebecca Graetz, EdDInstructor
Annette McNamara
