|
 Based on survey responses from 240 transgender and gender
nonconforming people, researchers say negative experiences were
often attributable to doctors' lack of knowledge.
"The biggest recommendation that came out from what we saw and what
participants actually said was training," said Dr. Makini
Chisolm-Straker, the study's lead author from the Icahn School of
Medicine at Mount Sinai in New York. Training of medical staff
"should be systematic and it should be required."
People who are transgender or gender nonconforming identify as a
gender different from the sex assigned at birth, or do not identify
their gender as explicitly male or female.
"Basically, I wanted to find out from trans folks across the U.S.
what their experience was in emergency departments," Chisolm-Straker
told Reuters Health.
For the new study, researchers surveyed transgender and gender
nonconforming adults who visited U.S. emergency departments between
2012 and 2014. Participants were recruited from health centers
serving the lesbian, gay, bisexual and transgender communities,
Facebook, a national conference and word of mouth.
Two themes that emerged from the surveys were self-efficacy, which
focused on the person's need to speak up for themselves, and power
inequity, which dealt with the dynamic between patient and provider.
Regarding self-efficacy, the researchers found, people who had
others advocate on their behalf - such as a primary care doctor or
family member - felt respected. People who had to advocate for
themselves didn't have positive experiences and some didn't feel
like they could speak up.
As for power inequity, the survey responses revealed, doctors were
often unprepared to account for their patients' needs as related to
their gender identity.
One respondent recalled a junior doctor saying, "I don't understand
your body. I will just consider you female, but who knows what those
hormones you are taking could be doing to you."
Patients shouldn't need to teach their doctors about transgender or
gender nonconforming healthcare, but they often do, said
Chisolm-Straker.
"When patients had to teach their clinicians about medicine, there
was a bad dynamic," she said. "It became clear the clinicians were
uncomfortable."
[to top of second column] |
Respondents also recalled healthcare providers using the wrong names
or pronouns. Some people also felt like they were being put on
display or that their gender identity was unnecessarily the focus of
conversation.
The respondents offered some suggestions for doctors.
About 45 percent suggested that providers should ask patients for
their pronoun and name to use throughout care. About 36 percent
suggested not asking about gender identity unless it's relevant to
care. About 23 percent suggested not discussing a patient's gender
identity and related health histories with anyone unless it's
relevant to care.
Chisolm-Straker said eliminating these issues will take a
multi-level approach from the top to the bottom. For example, she
said, it requires people to do research and support from those who
oversee health systems.
Another important tool is for accrediting bodies to require a
certain level of training, as they do for intimate-partner violence,
she said.
"I don’t think it will go away in my lifetime, but I hope it will be
a lot less of an issue," said Chisolm-Straker.
SOURCE: http://bit.ly/2lAhd2D Transgender Health, online February 1,
2017.
[© 2017 Thomson Reuters. All rights
reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
