At the Trans-ilience Lab, our team is committed to not only collecting information through research, but also disseminating that research so it can be used to improve the lives of transgender and gender diverse (TGD) individuals. Several members of the Trans-ilience team have contributed to an ongoing research project on minority stress and healthcare and in 2022 they published an article providing insight into recommendations of the study participants in regards to improvements in healthcare for TGD patients. This information was gathered from surveys with 420 TGD study participants about what improvements they felt would decrease barriers to accessing healthcare for TGD people.
TGD people face unique barriers in accessing healthcare, such as unknowledgeable providers, minority stress/discrimination, and financial barriers. These barriers are likely to be compounded for individuals experiencing multiple types of minority stressors, particularly TGD people of color. These barriers are a major issue for TGD people in accessing healthcare and can result in negative consequences, such as delayed care, not accessing healthcare at all, or fear/anxiety about accessing healthcare.
There were 6 main recommendations for healthcare providers that emerged from this research: eliminate cisnormativity, take an individual and holistic approach to care, reevaluate standards of care for TGD healthcare, reduce accessibility issues, improve interactions with patients, and improve provider/staff training. There were also several overarching themes, including that it is important to reduce the power imbalance which leaves TGD patients at the mercy of healthcare providers, to listen to TGD people about what they need, and to be proactive in addressing the concerns of TGD people.
To eliminate cisnormativity, one must first understand what cisnormativity is. Cisnormativity is assuming everyone’s gender is the same as their sex assigned at birth. Cisnormativity can include using the incorrect pronouns for someone or denying care to TGD patients. To eliminate cisnormativity, providers need to recognize and respond appropriately to cisnormativity and uncouple gender from bodies. In order to take an individual and holistic approach to care, participants recommended providers recognize nonbinary identities as valid, use gender neutral language, and employ minimally invasive protocols to minimize dysphoria.
As a part of reevaluating standards of care, participants highlighted the importance of removing gatekeeping and moving on from outdated standards. Previous standards of care required letters of support from mental health providers to access gender affirming care, but many have questioned whether this is a best practice. Requiring such letters from mental health providers also contributes to the financial burden on TGD people who want to access gender affirming care, which is already significant. Reducing financial burdens, increasing locations/providers, clearly marking TGD-inclusive providers, providing gender neutral restrooms, and employing TGD people are all ways providers can increase accessibility for TGD patients.
There are several key factors that participants suggested for improving interactions with TGD patients, including using affirming language, respecting confidentiality/privacy, focusing on the immediate health concern, and maintaining a special regard for TGD minors. Healthcare providers can support youth with difficult family situations and have a key role in protecting TGD patients’ safety by not outing them. Finally, the necessity of improved training was a frequent comment. This also removes the burden of educating a provider from TGD patients, when that information should be standardized into education for healthcare professionals.
To see an infographic of the study results, click here.
To read the full article, click here.