Many transgender and gender diverse (or, trans) people experience discrimination, harassment, and violence within healthcare services (including physical and mental health). According to the US Trans Survey, a third of participants who saw a provider in the past year experienced at least one negative experience with a provider related to them being trans. Research from our lab also has shown that about 1 out of 4 trans participants reported experiencing discrimination within a healthcare context (Puckett et al., 2019). Many trans people also report negative experiences in therapy, such as therapists over emphasizing their gender, gatekeeping, or other microaggressions (Morris et al., 2020).
Trans people deserve to have access to high quality and affirming care, but given the many barriers that exist, such as provider lack of education or mistreatment by office staff (Puckett et al., 2018), they may not be able to find a competent and affirming provider. As a result of this, trans folks may avoid seeking healthcare when needed. Healthcare avoidance due to fear of discrimination is related to worse general health, as well as higher levels of depression, suicidal ideation, and suicide attempts (Seelman et al., 2017).
There is a growing literature about steps that providers can take to improve their care and make their services inclusive for trans clients or patients (Hope et al., 2022; Puckett, 2019). Even so, many providers get little to no training in their graduate education about how to approach care with trans individuals from an affirming and competent stance. One study found that only 29% of therapists felt sufficiently familiar with the experiences of trans people to provide affirming care. Similarly, medical providers receive little training in working with trans patients (Dubin et al., 2018).
Given this, we have reviewed the literature, reflected on our own personal and professional experiences, and collaborated with our team's Community Advisory Board to develop a list of strategies that providers can take to improve their services. One of our team members, Belle Hoke, is working to create a video series detailing some of these steps in the hopes of helping providers improve their care and to provide some educational tools.
At the core of improving one's approach is a need to reflect deeply about your own biases and assumptions about trans people's lives (Stroumsa et al., 2019). There is likely significant personal work that some providers must do to shift their mindsets and beliefs about trans people. We hope that providers will take the time to engage in that reflection and unpacking of their own biases. Beyond that, this series can help providers learn some more specifics about how to make their approach to care, their setting, the forms they use, and other aspects of trans people's healthcare experiences more affirming.
The video series will be available on our YouTube channel at: https://www.youtube.com/channel/UCUEAm-vkBlf0oyLBSkF7GUA
The first two videos are available as of today and more will be added soon!
