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Equal Care for Transgender Patients Reinforced by HR Policies

Analysis  |  By Lena J. Weiner  
   November 21, 2016

Responsible hospitals are training staff to ensure that transgender patients receive equal care. The "assume nothing" mantra is working for one Massachusetts hospital.

Sue Boisvert, a risk management professional from Maine, never expected the "important news" her daughter had to share after her first semester in college was that she had begun the transition to become male.

Within a year, Sue's child had legally changed his name, began taking testosterone, and had his birth certificate, driver's license, and insurance updated to reflect his male gender identity. As a supportive parent, Boisvert accompanied her son, who had taken the name Emile, to his medical appointments.

While most healthcare providers treated Emile with respect, the Boisverts soon realized they couldn't take professionalism for granted.

When Emile contracted a urinary tract infection and had to seek urgent care at a local clinic, he told the nurse completing his registration that he was taking testosterone. The nurse made "very inappropriate comments," clicked her tongue, and rolled her eyes, says Boisvert. "It was very hurtful to us."

But this experience is not uncommon for transgender people seeking care.


Stopping Harassment Starts with HR


An estimated 1.4 million adults in the United States identify as transgender and they face discrimination regularly. In 2015, one in five transgender people reported postponing or skipping healthcare in the last year due to fear of discrimination.

"Transgender individuals are often subjected to what's called 'microaggressions,' " says Boisvert.

In these cases, healthcare workers may subtly show disrespect for or discomfort with a transgender patient by rolling their eyes or other gestures, refusing to take the patient's condition or gender identity seriously, using incorrect pronouns, or through condescension.

But ensuring transgender patients receive appropriate care isn't just the right thing to do, says Lisa Rabideau, director of patient relations and service excellence at South Shore Hospital in Weymouth, MA. Hospitals have a responsibility to provide excellent care and treat all patients with dignity and respect.

While South Shore Hospital, a 370-bed hospital 15 miles south of Boston, sees only about "half a dozen" transgender patients yearly, its staff make it a point to ensure they feel welcome, says Rabideau.


LGBT Health Disparities Persist, But Nurses Can Help


When providers fail to do that, patient trust suffers. There are multiple ways HR can encourage fair treatment of transgender individuals within their health system.

South Shore Hospital, where Emile has received care, offers frequent training series on diversity. "We do diversity training throughout the year, every year," says Rabideau.

In addition to monthly classroom programs focusing on diversity, Rabideau and her team have hosted lunchtime kiosks on diversity-related topics in the hospital cafeteria and have hosted webinars staff could download at their own convenience.

All South Shore Hospital staff and clinicians are required to commit to the facility's ASPECTS (Accountability, Service, Professionalism, Etiquette, Communication, Teamwork, and Safeguarding) standards even before applying for a job at the hospital.

South Shore's administration takes the standards seriously, says Rabideau. It's also important to make it clear that deviating from these standards of care for any patient is unacceptable.

Assume Nothing

When doing outreach or training healthcare workers to be aware of transgender patients and their needs, make "assume nothing" a mantra.

When in doubt, it's wise to ask what pronoun a patient prefers. "One thing that I've learned working with LGBT-identified people is that it's important to not make assumptions," says Rabideau. "What these people really want is to be treated equally."

She adds, "We have never had a patient complain about being in a room with a transgender patient."

Helping transgender patients feel welcome and comfortable isn't just good for transgender patients, says Rabideau—it ensures that the entire community trusts the hospital to provide non-judgmental care.

"People wouldn't come here if we didn't treat everyone equally," she says.

Lena J. Weiner is an associate editor at HealthLeaders Media.


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