Being transgender (also referred to colloquially as ‘trans’) involves special considerations when it comes to healthcare. According to GLAAD, transgender is an “umbrella term for people whose gender identity differs from the sex they were assigned at birth.” However, every person within this category may choose to describe themselves differently, and not use the term transgender at all. That makes it very important to “Use the descriptive term preferred by the person. Many transgender people are prescribed hormones by their doctors to bring their bodies into alignment with their gender identity. Some undergo surgery as well. But not all transgender people can or will take those steps, and a transgender identity is not dependent upon physical appearance or medical procedures.” Planned Parenthood reminds readers that “Transgender people have the same basic health care needs as cisgender people. They also have health care needs related to their transition and require competent care.” If healthcare industry is going to foster diversity and inclusion and eliminate bias, providing quality, affirming quality healthcare of the transgender patient population is an important component of this commitment.
The Commonwealth Fund offers that "The approximately 1.7 million trans people in the United States face significant hardships that increase their risk of poor health outcomes. First, two of five (39%) report having low incomes (i.e., earning less than $30,000 a year per household), which can have negative effects on health. In addition, trans people are more likely than the general population to face discrimination in education and employment, abuse by the police, harassment in public spaces, and physical, verbal, and sexual assault. Nearly all of these issues are worse for trans people of color." Being transgender comes with health challenges related to their status, for multiple reasons, including "the toxic stress of living as a trans person in America." The same source tells readers that "Trans people are more likely than their cisgender counterparts to report poor physical health, experience mental health issues like anxiety and depression, and have substance abuse problems. Forty percent have attempted suicide, compared with 4.6 percent of the general population."
Planned Parenthood states that "Accessing health care can be challenging for transgender people. Not all nurses and doctors are sensitive to trans issues or informed about the health care needs of transgender people." In addition, when treating transgender patients, some might feel uneasy with revealing a gender identity, sharing the wish to transition medically, or even undergoing a physical examination. The Commonwealth Fund reminds us that "Transgender people often face barriers to getting the health care they need. One of five transgender adults is uninsured. Trans people often skip health care because of cost: nearly half (48%) have postponed medical care when sick or injured and avoided preventive care (50%) because they couldn't afford it." Imagine the potential suffering involved when "Trans people often hide their gender identities from health providers out of fear of retaliation and harassment. Only 40 percent of trans people report being out to all their medical providers. It's understandable that many would want to conceal this information: 28 percent of trans people report experiencing verbal harassment in a medical setting and 19 percent report having been refused medical care by providers because of their gender identity. Because of stigmatization and harassment, 28 percent of trans people report avoiding care altogether."
The Commonwealth Fund also offers that half of transgender patients "report having to teach their medical providers about transgender individuals' health care needs and appropriate medical care. Lack of awareness on the part of medical providers—in part because of lack of training—has serious implications for care quality. Moreover, when people veil their identities in medical settings, their providers miss important information that should inform screening, diagnosis, and care." Clinicians need to understand what can happen for transgender patients experiencing hormonal imbalances as well as other issues connected to their identities.
Nurse Journal offers the following 7 suggestions for creating a more supportive healthcare environment when working with transgender patients:
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