Transgender patients have medical needs that many providers are not familiar with, but several hospitals are making strides to provide sensitive and effective treatment, Abby Ellin reports for the New York Times' "Well" blog.
Transgender patients can raise questions for providers: How do hormone treatments—such as testosterone therapy—affect cancer treatments? Do transgender women need be screened for prostate issues? Where should transgender patients be roomed during inpatient stays?
Some answers are fairly straightforward. For instance, Harvey Makadon, director of education and training programs at the Fenway Institute, says, "All transgender women still have a prostate gland, and a good clinician will need to … provide appropriate preventive screening and care."
For complex questions, advocates say it's important for doctors to be comfortable reaching out for further guidance. "I don't expect every doctor in the world to become an expert in trans medicine," explains Beck Bailey, a transgender man and deputy director of employee engagement at the Human Rights Campaign (HRC). "But I do think they should be knowledgeable enough to know what they don't know and pick up the phone and call an expert."
Some providers learning from experience
Unfortunately, many transgender patients say the health care industry is not always welcoming. According to a 2011 report from the National Center for Transgender Equality and the National LGBTQ Task Force, 19% of transgender patients said they been denied health care because of their gender identity. And a 2010 report from Lambda Legal found that 70% of such patients had experienced health care discrimination.
In some cases, transgender patients experience problems because of poor communication. Brooklyn Hospital Center spokesperson Joan Clark says her organization learned from a situation last summer when staff, not knowing a transgender woman's gender identity, placed the patient in a room with a male roommate.
Clark says she thinks the incident helped the hospital improve its practices and made it "a better organization."
"[Transgender patients] don't want different treatment, they just want equitable treatment," she says, adding that all employees at Brooklyn Hospital now undergo sensitivity training.
New policies focused on transgender patients' needs
Some hospitals have implemented policies to help make sure that transgender patients are comfortable when receiving treatment. For instance, at Massachusetts General Hospital all transgender patients are asked if they prefer a single or double room and how they identify their gender. "If the patient identifies as a woman, [she] will be placed in a room with a woman. If they identify as a man, they will be placed in a room with a man," explains Terri Ogan, a hospital spokesperson.
Mount Sinai Health System has housed patients based on their gender identity since 2013. Barbara Warren, the director for LGBT programs and policies at Mount Sinai, says it's a more efficient approach than housing transgender patients in single rooms, which can increase wait times for such patients admitted through the ED.
The most important thing, experts say, is to have clear policies in place. "The first time you think about where you are going to put a transgender patient should not be when they arrive," says Tari Hanneman, deputy director of the Health and Aging Program at HRC (Ellin, "Well," New York Times, 2/16).