Treating Transgender Patients

So your patient’s name is Samantha and goes by Sam. They “appear” male but are here for vaginal discharge. There is nothing in the chart about how your patient identifies. There is an elephant in the room… where do you go from here?

Now many of us providers have lots of experience treating transgender, genderqueer and non-binary patients, but many of us have absolutely NONE. The reality is that in many areas of the country these patients have to hide from getting medical care. Patients are scared to be treated badly, and therefore their health suffers.

Fortunately, in many areas of the community, it’s becoming more accepted and more common for transgender/non-binary patients to come to urgent care and their primary care offices for care. BE the provider that keeps those numbers increasing. Don’t prevent healthcare from happening. 

In the recent past and still in many communities, some of these patients would not seek medical help when needed and would become very ill to avoid having to deal with medical professionals that they did not know. They would only see known, “safe” providers who are not always available for urgent care/sick visits. It can be too risky to be seen by someone who may make them feel worse or who may refuse to see them altogether. Not everyone will accept these patients and treat them humanely as they deserve. The health care disparity for transgender patients is real. 

Here at Nurse-1-1 we realized that having only a male and female option was not inclusive enough. We saw the need for care for all humans and realized that we were unintentionally excluding a cohort of patients. After realizing our oversight, we made sure our service included non-binary patients. We added “non-binary” as an option for gender so that all patients would feel welcome to chat with us. We wanted to be sure we were creating a safe space for all patients. 

We want patients to feel comfortable with sharing their health concerns. And we strive to provide the best environment for our nurses to help as many patients as they can.

If you are feeling uncomfortable as the provider, imagine how your patient feels. It’s time to pull your big kid pants on and put aside opinions and biases. Don’t be afraid to ask questions. I mean, you aren’t afraid of blood and guts, so this shouldn’t be that much more difficult. Don’t forget we are all human. You may feel strongly that you are a female or male, but your patient may be struggling with that label, especially if they feel like they don’t belong.

Now when I say struggling, I don’t mean they are confused. I mean that they might not fit into the typical label they appear to be and that they were given at birth. Your patient may have a penis but identify and appear to be a female. Don’t assume, ask. Let your patient tell YOU how they identify. 

Don’t guess. Guessing is ignorant. ASK your patient! How would they like to be called? He? She? They? Ask what name they would like to go by. Put it in the chart, make it clear. It doesn’t have to be permanent, these things change. But make it easy. Help out your colleagues, spare your patient from having to explain to each person who enters the room. 

Respect your patient. You don’t have to understand or agree with your patient’s label and identity. You aren’t there for that. You are there to address the issue at hand. This issue is their current illness and symptoms. They are unlikely at the urgent care center today because they want you to help them choose how to dress and act and who they should have sex with. They are here because they have acute symptoms and need your help. 

Your patient in your office is brave and strong. Some patients just can’t bring themselves to come into the office in person, but need medical help. Nurse-1-1’s text based triage service will allow your patients to connect with a health care provider. One of our goals is to be part of the health care solution and decrease disparities. If you feel like we can help you be a part of this, let us know, there are options to help make your clinic one that is accepting of all patients. Make the changes necessary to be that change! 

Next let’s not assume that Sam isn’t sexually active with men. In fact don’t assume anything. Sam’s vaginal discharge and abdominal pain could be due to pregnancy. Don’t assume that Sam, who identifies as male, is only sexually active with women. Gender identity doesn’t specify sexual orientation. Asking questions politely and respectfully will help you give the best care to your patients. 

Your patients who are hesitant to get medical care are at very high risk for health problems and complications. The health disparity they face must be improved. Offer care, encourage well visits and preventative care, be kind, support your fellow human. YOU might make the difference in their life. Offer them a safe place to come for health issues and concerns. Read up on how you can help these patients feel respected and cared for. Come out of your comfort zone. Keep them coming back to your clinic. Keep making improvements in healthcare and in the lives of others. We owe this to humanity. Be a provider who directly but respectfully addresses gender identify, and help improve health care disparities.