Fundamentally all people want to be treated with equity, however transgender patients may hesitate to access health services if they believe they may face discrimination.
Many transgender or gender diverse (trans) people delay or avoid seeking health care because they have had negative experiences in medical settings.
Specialist practitioners at the Albion Centre have emphasised that providing safe care starts before the patient walks through the door. Trans patients can experience multiple daily micro-aggressions, so considerations such as displaying trans insignia, and ensuring front desk staff have trans awareness can signal to patients that the service provider aims to be inclusive and provide a safe space.
While some practitioners may feel they have limited experience with trans health, they could already be treating trans patients who are not comfortable sharing their trans status. However, the provision of gender-affirming care and therapies has been shown to improve health outcomes for trans patients, and trans awareness can help fill the gap where continuity of care, or the establishment of trans-friendly health networks is not possible.
In some cases, technology has not yet caught up with trans-centred care, and adjustments such as informing patients when their legal name needs to be used on forms, or including a patient’s chosen name where possible, can help trans patients feel prepared when records may not align with their identity.
A spokesperson for the Gender Centre says transgender patients need to be treated with the same respect and personalised care a doctor would use toward any patient. “Just like any other person, a transgender patient is entitled to the right treatment, and the appropriate treatment for that individual.”
Considerations for working with transgender patients:
- Patient care is more than clinical care: Create an environment that welcomes everyone, including transgender patients: Use insignia such as posters or stickers that show racial and gender diversity. The front-line service team should also convey this message. At least one bathroom should be unisex.
- Forms should offer the option ‘chosen name’ or allow a blank option for ‘sex/gender’ where an individual can write their own gender description.
- Ask what name and pronoun the patient uses. Use these, even when the patient isn’t present. Consider introducing yourself with your own pronouns.
- Focus on providing relevant clinical care, if you need to ask questions about gender issues, clearly explain how the topic relates to the presenting health issue. If you are not treating a condition that relates to the genitals, there is no need to ask about them.
- Know when to refer. Transgender patients may experience a range of complex issues. Be alert for signs of homelessness, depression, poverty, social isolation, drug and alcohol problems. Keep an up-to-date list of resources and agencies where you can refer a patient.
- Provide personalised care, where a trans patient does not need to repeat their story at every step of their health care journey, and ensure referrals include relevant patient history. Establish patient feedback loops where possible, to help create safe networks.
- Tackle staff discrimination. Train other staff members about transgender issues, including what language to use. This is extremely important as non-clinical staff do not have access to the same education as doctors are able to and expected to complete.
- Confidentiality matters. Transgender patients are entitled to the same privacy as any other patient.
- TransHub - Supporting my trans clients and patients
- NSW Health LGBTIQ+ Health Strategy 2022-2027
- The Gender Centre
- 10 tips for working with transgender patients: An information and resource publication for health care providers
- Centre of Excellence for Transgender health