#Transhealthfail Exposes the Need for Transgender-Specific Training in Healthcare

When you experience discrimination, it’s easy to feel like you’re alone. The very nature of discrimination is isolating: the minority is singled out for insults, ridicule, or poor treatment from the majority, and for transgender people, the numerical difference between majority and minority is huge. A 2011 study put the U.S. transgender population at an estimated 0.3 percent. Although a definitive count has never been performed, that estimate gives a sense of scale to trans people’s experiences as they fight for recognition and respect.

One of the most daunting and pervasive forums for anti-trans discrimination is the health care system. The landmark 2011 transgender discrimination study Injustice at Every Turn reported that 19% of trans people studied had been refused care due to their gender identity, 28% had postponed care due to discrimination, and a staggering 50% wound up educating their own doctors about trans issues. Yet it’s easy for individual trans patients to feel like they’re the only ones being treated this way.

Enter social media. The hashtag #transhealthfail was started by @MyTransHealth, an upcoming website that is building a database of transgender-friendly health professionals. (Their Kickstarter is here – and Philadelphia coverage is among their stretch goals!) The first tweets invited trans folks to share their negative experiences with healthcare providers, and the hashtag quickly exploded.

These posts reveal a daunting, often hostile environment for transgender patients. Some were misgendered, outed, or ridiculed in public:

#TransHealthFail “You’re the first ‘they’ person I’ve ever treated. I mean, I’ve had several young women come to me who use ‘he,’ but…”

— Klaus Thariaro (@KlausThariaro) August 6, 2015

Nurse:”When was your last period?” Me:”Never. I’m Transgender.” Nurse:”You really fooled me! I thought you were a woman.” #transhealthfail

— Julie Rei Goldstein (@JulieRei) July 30, 2015

In the ER, the nurse in an open space yelled to the doctor “Can you believe it? THAT [pointing at me] used to be female!” #transhealthfail — Ira D. Sanchez (@IraSanchezLGBT) August 5, 2015

Others were questioned or dismissed by doctors with narrow-minded or uneducated views of trans people:  

Doc: “No self harm, no suicide attempts, you didn’t self-medicate. Are you *SURE* you’re gender dysphoric?” #transhealthfail — Anastacia Tomson (@anaphylaxus) August 6, 2015

my psychiatrist told me i’m just confused about my gender because i haven’t known since i was 2 years old #transhealthfail — tony ✨ (@akchilles) August 7, 2015

Therapist: Are you bisexual, heterosexual, homosexual, or transsexual? Me: Wait, what? #transhealthfail

— Emily Prince (@emily_esque) July 30, 2015

 

And still others highlighted the serious failings of insurance coverage for transgender people in the U.S.:  

Demand people endure Real Life Experience but don’t support them with hormonal therapy while they do it. That is barbaric. #transhealthfail — Anastacia Tomson (@anaphylaxus) August 6, 2015

Having to pay thousands of dollars since life saving surgeries for trans people are ‘cosmetic’ #transhealthfail

— noah (@_noah_og) August 6, 2015

#transhealthfail If I change my insurance gender marker to M, it’ll pay 4 HRT, but not reprod care. If I keep F, I have to pay for T myself

— Kieran (@QueeringPsych) August 6, 2015

 

The tweets go on – and to date, they show no sign of stopping. Although it’s terrible to see so many horror stories, the attention #transhealthfail is getting is encouraging. It is my hope that all of these tweets, shares, articles, and replies will spark support not only for political action – the passage of laws that ban discrimination and ensure health care access for all trans and non-binary people – but for transgender-specific training for health providers.

I got involved in healthcare training in 2013, just two years after I started my medical transition. I had previously spoken to college students and activists about transgender identities, but had never thought about addressing the medical community until I was asked to give a workshop at Good Shepherd Penn Partners, a physical rehab center in Philadelphia. They had recently served a transgender patient and were looking for ways to improve future care. I agreed, but the night before the presentation, I was getting nervous. Medical professionals go through years of school and training, I told myself. What could I tell these doctors and nurses that they didn’t already know?

It turned out that I had a lot to offer. The professionals I spoke with were all at the top of their field, yet many of them had never been trained in transgender issues. Every one of these doctors and nurses wanted to do their best for patients of all genders – they just didn’t have a lot of experience with the terminology, the range of identities, and the personal stories of trans people.

After the session, the organizer walked me to my car, and it was clear that the workshop had made a difference for her. “We just never talked about this back in medical school,” she explained to me. “I mean, for a lot of us, our training was ten or twenty years ago. They weren’t discussing these types of issues back then. Just having a vocabulary reference, knowing what to say and what not to – that’s huge!”

As I continued speaking at hospitals and clinics, I quickly realized the difference that a training session could make for both providers and patients. While there are certainly doctors who discriminate against trans patients out of bigotry and fear, I believe there are many more who want to be allies to the LGBTQ community – but they need the tools to do so.

We must champion comprehensive training and professional development for medical professionals – training that prepares them to treat transgender patients with compassion and respect. Of course, this training must start in medical school, but it must also extend beyond the classroom so that we can reach professionals who are already working in the field, and so that providers can keep up to date with best practices.

The best way to avoid a #transhealthfail is to teach our doctors, social workers, receptionists, nurses, security personnel, therapists, and everyone involved in patient care about transgender identities. This is not the job of the patient. It is the responsibility of the institution to seek out knowledge and to better serve the trans community.

Healthcare providers: Please step up and ensure that your staff have the knowledge they need to provide transgender patients with the highest standard of care. Let’s put the #transhealthfail hashtag out of commission for good.