Transgender Healthcare

Submitted by Tristan Dorn

Many Americans have health disparities due to barriers in access to competent, quality care. Additionally, some citizens are turned away at the door of medical practices when they do try to access care. Unfortunately, the 700,000 members of the transgender community in the United States are part of that stigmatized group. Of this population, 7500 transgender people live in the DFW area.

Transgender people have many of the same healthcare needs as their cis gender counterparts, but they also have disparities and different rates of diseases and medical conditions present in their population. For example, 40% of lesbian, gay, bisexual, or transgender youth have either attempted or seriously contemplated suicide. Additionally, transgender people are at increased risk for STIs including HIV and physical abuse.

The Affordable Care Act formally banned sex and gender based discrimination in healthcare facilities that receive federal funding, however problems still exist in regards to transgender people. This population still suffers with difficulty obtaining healthcare, health provider insensitivity, and even insurance plans still having exclusionary plans for transgender related care. Many members of the transgender community anticipate being met with uncertainty, especially because care for this population is often excluded from a physician’s medical training. Additionally, some providers are uncomfortable with transgender populations due to bias, ignorance, or a lack of exposure or education of proper clinical interactions. A study titled “Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions” revealed derogatory comments and discriminatory care of LGBT patients. Additionally, 28% of Transgender patients had experienced harassment in medical settings, 19% were refused care, and 2% experienced violence in their doctor’s office.” Due to this refusal for care, stigma, and discrimination, many transgender individuals seek care on the black market or forego care entirely. This stigma works directly to induce stress and indirectly by restricting access to health protective resources.

Ways to provide competent care include asking patients their preferred name and pronoun, posting non-discrimination policies, ensuring confidentiality, and offering sensitivity training for staff. These are all steps that signal acceptance and let patients know that they will be treated with dignity. Other clinical office means to display that a facility is able/open to providing care to this population include hanging posters, putting out brochures and flyers, and spreading by word of mouth that we offer care to people who identify as transgender. While note every clinic in the DFW area is going to provide the best resources for a transgender patient, there are some resources available to this population. Organizations such as the Resource Center, North Texas Gender Friends (NTGF), Trans-Cendence International, and Transmigration all provide support and social networks for the transgender community.

 

Sources:

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Gupta, Sarika, Katherine L. Imborek, and Matthew D. Krasowski. “Challenges in Transgender Healthcare: The Pathology Perspective.” Laboratory Medicine 47.3  (2016): 180-88. Oxford Academic. Web. 10 Apr. 2017.

Kelley, Leah, Calvin L. Chou, Suzanne L. Dibble, and Patricia A. Robertson. “A Critical Intervention in Lesbian, Gay, Bisexual, and Transgender Health: Knowledge and Attitude Outcomes Among Second-Year Medical Students.” Teaching and Learning in Medicine, vol. 20, no. 3, 2008, pp. 248-53. Web. Accessed 4 Apr. 2017.

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Lombardi,E. “Enhancing Transgender Health Care.” American Journal of Public Health, vol. 91, no. 6, 2001, pp.869-672. NCBI.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446458/pdf/11392924.pdf Accessed 6 Apr. 2017.

Thapoung, K. “The Transgender Community by the Numbers.” Marie Claire. 28 July 2015. http://www.marieclaire.com/culture/g3065/transgender-facts-figures/

The American College of Obstetricians and Gynecologists. “Ob-Gyns: Prepare to Treat Transgender Patients.” Obstetricians and Gynecologists, vol. 205, no. 6, 2011. http://www.acog.org/About-ACOG/News-Room/News-Releases/2011/Ob-Gyns-Prepare-to-Treat-Transgender-Patients?IsMobileSet=false . Accessed 6 Apr. 2017.

“Texas judge halts federal transgender health protections.” Dallas News. The Dallas Morning News, 31 Dec. 2016. Web. 09 Apr. 2017.

White Hughto, J.M., Reisner, S.L., & Pachankis, J.E. “Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions.” Soc Sci Med, vol. 147, 2015, pp.222-231. HHS Public Access. doi:10.1016/j.socscimed.2015.11.010. Accessed 6 Apr. 2017.

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