3 Keys to Connect With Transgender Patients

Debra Shute, November 9, 2017

Two healthcare centers offer ways for clinicians to build their competence in serving the transgender population.

Most likely, you already care for transgender individuals in your hospitals or clinics. Whether you provide gender-affirming services or not, there are a number of ways to increase your competence in caring for this population.

It is estimated that about 1.4 million American adults, (0.6% of the adult population), are transgender, meaning that they experience their gender differently from that assigned their bodies at birth. These individuals experience a persistent discomfort with gender identity, causing extreme distress.

As a result, these people may seek to affirm their gender identity in any number of ways, ranging from changing their names and style of dress to undergoing surgery.

1. Appreciate the Hurdles

In 2008, the American Medical Association declared gender-affirming hormones and surgery medically necessary for transgender individuals; however, obtaining insurance coverage for such interventions remains a widespread struggle.

If such patients are among the 33% who report having negative healthcare experiences related to being transgender, they’re at high risk for avoiding any type of healthcare at all, says Alex S. Keuroghlian, MD, MPH, director of education and training programs at The Fenway Institute at Fenway Health in Boston. He is also an assistant professor of psychiatry at Harvard Medical School.

And that’s far from the only troubling statistic collected by the 2015 U.S. Transgender Survey, which included anonymous online responses from more than 27,000 transgender individuals throughout the country.

In addition:

  • 39% of respondents experienced serious psychological distress in the month prior to completing the survey, compared to 5% of the U.S. population.
  • In the year prior to the survey, 23% of respondents did not see a doctor when they needed to because of fear of being mistreated, and 33% avoided seeking care because they couldn’t
    afford it.
  • 25% of respondents experienced problems with their health insurance in the prior year that were related to being transgender.

2. Promote Education

Joni Steffens, APRN, CSC, director of the new Gender Medicine program at CentraCare Health in Central Minnesota, estimates that she’s given at least 25 presentations over the past year throughout her healthcare system and the community to educate people on transgender issues.

"I didn’t often wait to be invited," she says.

"I've pretty much said that I would like to come and talk, and our groups have been very willing to at least let us open the door and have those conversations. And we’ve made ourselves extremely available to anybody."

Debra Shute

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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