Fellowship Winner Bailey Ferris Plans to Center Research on Improving Quality of Care for Trans, Nonbinary Patients

For a provider unfamiliar with the transgender/nonbinary community, having conversations with patients can be difficult, Ferris acknowledges.

Bailey Ferris was 19 and working as an EMT when he noticed a disconnect in how providers around him delivered care to transgender or nonbinary patients.

Ferris identified with the patients because he, in fact, was transitioning at the time.

Now, as one of three fellows for the Emergency Nurses Association’s (ENA) ENDVR fellowship, Ferris plans to center his research around how lack of guidance for emergency nurses providing care to transgender or nonbinary patients leads to distress and a decrease in quality of care.

“While it’s gotten better over time, there’s still a really serious, considerable disconnect between what we know about basics that people need to feel safe in a healthcare environment, and what most people are comfortable with and able to handle,” he explained.

For example, paramedics or emergency room  nurses  may ask a patient what their pronouns are and see the  patient’s legal name but not ask whether there’s another name they’d prefer to be called.

Ferris said the disparity between what providers perceive the transgender/non-binary community’s needs to be and what those needs really are, is “astounding.” He also acknowledges that for a provider who’s not familiar with the community and doesn’t have the vocabulary, it can make having conversations with patients difficult.

“I think that training for people to, at minimum, be comfortable with pronouns, comfortable with body questions, understanding what the appropriate limits are for what to ask, and when, should be an interactive process, because what we’re doing is talking to patients,” Ferris said.

In doing so, he hopes to establish the benefits of that kind of training as evidence-supported fact, or move forward with better practice guidelines about the value of having those kind of conversations  before they’re put in a situation where they would need to use  that knowledge.

“In terms of research, I also think there’s some questions that we haven’t been addressing because a lot of that has been built on assumptions from people who aren’t trans, saying, ‘Oh, this is the best way to take care of trans people.’ And that’s not necessarily true,” he said.

Ferris sees the ENDVR fellowship an opportunity  to explore  in-person provider training for providing care to transgender/nonbinary patients.

Other topics he hopes to explore in his research are the assumptions around providing care for this community. , such as  lack of knowledge about hormones and how they affect people’s bodies and lack of awareness about medical versus psychiatric needs. Sometimes, he said, a provider will assume the patient has a mental health need when, in fact, they need medical assistance.

Ferris hopes to produce multiple pieces of research during his fellowship period, interviewing transgender and nonbinary individuals about their healthcare experiences to get a more informed perspective.

“I think there’s a lot of things that we do in healthcare either from the patient interview aspect or even from the aspect of medical care that are based around the assumption that you look like a woman, you have these parts, you have this hormone balance, you have these medical needs. And some of that is true,” he said. “But I don’t feel like we’ve really done diligence in examining where that line should be.”