Transgender patients need better inclusion in health care

By Catherine Wheeler

The Genderbread Person helps define ideas of identity, sexual orientation, sex, and expression. Photo courtesy of

ORLANDO — While transgender people may be more accepted in society, there is a lack of progress in transgender health care, advocates say.

In a 2015 survey from the National Center for Transgender Equality, 33 percent of transgender people said they had “at least one negative experience related to being transgender” when they saw a health care provider.

Additionally, 23 percent of people in the survey said “they did not see a doctor when they needed to because of fear of being mistreated as a transgender person.”

Those rates are higher among transgender people of color, the survey found.

Dr. Laura Arrowsmith, a physician for transgender care and a board member of the National Center for Transgender Equality, was part of a panel discussing care for transgender patients at the Association of Health Care Journalists conference in Orlando on Friday, April 21, 2017. The panel included a call for providers to educate themselves more about transgender patients.

Arrowsmith said the survey is one of the most comprehensive of its kind, reaching 27,715 transgender people. Arrowsmith said 1.4 million adults in the U.S. are transgender. It’s challenging to measure numbers of children and teens who are transgender, she said.

Arrowsmith said that being transgender is not a mental illness, but it can have serious mental health effects, including experiences with depression, substance abuse and self harm.

About 40 percent of transgender people attempt to take their own lives, according to the survey.

More education is imperative to creating safe health care access for transgender people, she said.

Arrowsmith said there is a need for more education in medical schools and residency programs so that new doctors will understand how to talk with and more effectively treat transgender patients. A simple step she suggested would be having broader intake forms for patients be able to accurately identify themselves.

“It takes the conflict out of the situation when they walk in,” said Gina Duncan, the transgender inclusion director for Equality Florida.

Duncan pointed to a guide by the Human Rights Campaign, Lambda Legal and the LGBTQ Rights Committee of the New York City State Bar Association that assists health care professionals in learning about how to effectively care for transgender patients. The guide was most recently revised in May 2016.

Health care lags behind other industries, said Duncan, who helps educate companies on transgender equality.

That might be because transgender healthcare started as a highly specialized field, with few specialists in the country. Now, the demand for quality resources for transgender health care has increased.

Providers such as Planned Parenthood have stepped up to provide ore options in hormone therapy and endocrinology, which are important elements of transgender health care. But it’s time for doctors to step up, Duncan said.

Duncan said she wants healthcare providers to create best practices for treating transgender patients.

Changing the system will help give transgender patients the respect and dignity they deserve, Duncan said.


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