Care of the Transgender Patient: A Survey of Gynecologists’ Current Knowledge and Practice
A study by the National Center for Transgender Equality and the National Gay and Lesbian Task force with other medical professionals conducted a survey report on health and health care 2010 in the United States. This report included challenges getting “preventive medicine, routine and emergency care, or transgender-related services.” These encounters getting medical care and ignorance behave the medical providers have discouraged transgender and gender non-conforming people away from obtaining better healthcare. (The survey uses gender non-conforming people, which are similar to gender variant people so either could appear in these blog posts). Not having access or being denied to health care is something that transgender and gender non-conforming people deal with more than realized. Since healthcare is a fundamental human right no one should be turned away from it. Patients should be just patient and should be treated for whatever health or medical care they require due to their needs.
In 2008, this study was lunched to address discrimination and over 7,000 people participated answering 70 questions survey. The questions involved all concern dealing with transgender discrimination like “housing, employment, health and health care, education, public accommodation, family life, criminal justice, and identity documents.” (pg.2) This study’s goal was to highlight aspects that are under looked by the media, lawmakers, and healthcare providers.
According to the survey the key health care findings were: high levels of postponing medical care due to sickness or injury when there was discrimination was about 28% and enable to afford medical care was 48%. Individuals faced challenges with getting health care or faced refusal of care at 19%. About 28% of the individual in the study faced harassment and 2% experienced violence in the doctor’s office. Next the most eye opening finding that 50% of the medical providers lacked knowledge in this sample about transgender care. However, majority of the individuals in this did have access to some type of transition related medical care, when it had to deal with getting surgery or not. There are also high levels of HIV infections reported by the people this study at about 2.64%, while 0.6% in the general population. Transgender women had the rate of the HIV infection at 3.76%, the unemployed 4.67%, and sex worker at 15.32%. The survey indicates that about quarter of the individual in the study “misused drugs or alcohol specifically to cop with the discrimination they faced due to their gender identity or expression.” (pg.1) About 41% part takers indicted attempting suicide, which is extremely high comparing to the general population that is about 1.6%.
The study includes other areas of transgender and gender non-conforming people’s experience that talks about if people know if someone is transgender or not, which the is mostly very uncertain according to the figures in the study. There is mention of ‘outness’ that the LGBT+ community understands is a process that should self-empower and involve understanding form the public. There are positive effects from coming out in gay, lesbian, and bisexual but for transgender or gender non-conforming people it all over place. Only 28% say that they were out to their medical providers and 21% say they were not and others were in between. Since transition is a process, which many go through, but it not true for all transgender and gender non-conforming people. Some go away from the idea of living life as the gender giving at birth with any medical procedure and other go through procedure to be the “embody their gender.” (pg. 3)
Both male-to-female and female-to-male transgender are analyzed in the study, along with gender non-conforming individuals who are further divided on the concept. These individual for basic medical care usually went a doctor’s office 60% of the time and 28% went to clinics or healthcare centers and just 4% seek emergency care. The worse medical care experience was in the emergency room, which explains the lower percentage for one to get any type of medical care. Individuals who used emergency room care were 17% African-American and 8% Latino, the income of 8% was under 10,000 per year and 17% were unemployed and 13% who used ERs had the education with less than high school diploma.
The subjects in the study experienced discrimination by doctors and hospitals was 24% and 13% in ETs, where female-to-male indicated higher levels of unequal treatment than male-to-female. Unequal treatment for Latino/a patients was also reported by the doctor (32%) and in the ERs or healthcare clinics (19%). But altogether 19% of the subjects in the survey were refused treatment by doctors or other health places. This is just highly unethical; doctors or healthcare provides cannot refuse treatment for patients or should not be able to. Steps should be taken towards these types of treatment by the law make or a reform that fights against such hardship in getting medical care. Refused care in divided into race categories that describe the percentage for Native Americans at 36%, 27% for Multi-racial, 22% for Hispanic, 19% black, 17% for white, and 15% for Asian. Also refusal by one’s gender identity was even higher; for male-to-female was 22%, female-to-male 19% and last for gender non-conforming people was at 6%. Transgender and gender non-conforming people face many types of harassment but harassment at a doctors office or a healthcare facility is wrong at a different level, about 28% subjects indicated verbally harassed in a medical setting.
Next, the survey focuses on the health care provider’s lack of knowledge, which the subjects said was often to deal with ignorance by the health care provides. Some even said that they had to “teach [their] provider” to get the medical care they needed. It was 50% of the subjects said they taught their healthcare provider at some level. This can be due to the lack of transgender care taught in medical school or even hospitals requiring their doctors to be familiar with transgender and gender non-conforming medical. Due to which many postpone the necessary and preventive medical care. In the general population about 15% do not have healthcare insurance but compared to the participants in this study about 19% do not have healthcare insurance.
Lastly, counseling is very important in transition that 75% of the participants said they received related to their gender identity. People who identify themselves transgender, about 80% of them were more likely to get counseling and those who are gender non-conforming seek counseling at 48%. Also people who have medically transitioned 89% of them received counseling and 91% who had some type of surgery. These are great numbers that people are seeking care for the burdens that society puts on them; medical care is important at all the stages of one’s life so it should not involve difficulty on its accessibility.
