What does it mean for transgender people to get medical care?
Courtesy Alexander Freeman  (New York)  When Alex Freeman, 22, a member of the transgender community, seeks medical care, he quickly commits himself to confusion, doubts, or potentially life-threatening mistakes. Freeman of New Brunswick, NJ, said he had had the best surgery two years ago and was mistaken for a cisgender man despite being in the hospital for a transgender-related surgery. .. Recently, when trying to get treatment for eczema, a dermatologist didnt know how a potential drug would interact with hormone therapy to confirm his gender, so he needed to look for care. Freeman said. It didnt come from a sneaky place, [the dermatologist] It was still confusing, said Freeman, a recent graduate of Rutgers University. I felt very defeated.  Freeman, who began the transition in the summer before his first year of college, said anxiety about going to the doctor led him to avoid going altogether in some cases. Even going to an obstetrician and gynecologist was one thing I did, he said. Both my grandmothers had cancer, but its dangerous because Id rather not want to go.  As part of the transgender community, data show that Freeman is not the only person whose gender identity is different from the gender assigned at birth to feel discriminated against while seeking medical care. I will. According to a 2015 U.S. Transgender Survey published by the U.S. Transgender Equality Center, nearly one-third of the more than one million transgender people in the United States are denied medical care because they are transgender. He reports that he has been harassed by medical professionals. A previous study published by NCTE found that nearly half of transgender people had to teach clinicians about the care they needed. Similarly, many transgender people stop seeking medical care, experts say. Were used to thinking that doctors know everything, so its scary to come in and encounter these uncertainties, Freeman said. There is nothing to apologize for, so it takes a lot of determination and resilience to stop apologizing for being a difficult patient that I continue to lack.  Discrimination can take many forms  For Naomi, a 22-year-old transgender woman living in Ann Arbor, Michigan, her anxiety about going to the clinic is due to microaggression, the self-proclaimed jab.  I remember going to the doctor for stomach cramps, and after I sat down with the doctor and they examined me, they canceled the woman on my chart and wrote in the man She said. ' She pointed to her favorite name. Thats the last thing I need to hear.  Discrimination that transgender people may face in hospitals and clinics asks or uses the wrong name from doctors who believe that health problems are related to the gender identity of the patient. It can even extend to potential front office staff. According to Sara E. Wiener, LMSW, director of the Comprehensive Gender Services Program in Michigan Medicine, patients are mispronounced. When I went to the emergency room of such a hospital system, I heard from a patient that they wouldnt touch me. They put on extra gloves. They didnt want to see me. They used my birth name instead of my favorite name and I felt like a monster, she said. These are the kind of things that transgender people are dealing with.  According to Wiener, experiencing medical discrimination is doubly devastating for transgender people who are already facing a disproportionate proportion of discrimination and violence, and a higher proportion of mental health problems. When people have access to healthcare, they are vulnerable and can go wrong, Weiner said. So its very painful to be in a vulnerable situation and then to be discriminated against, and Im really with people.  According to Aydin Olson-Kennedy, LCSW, Executive Director of the Los Angeles Gender Center, being transgender is so relevant to the body that seemingly routine tests and medical examinations by a doctor can be anxious. ..  For many transgender people, including himself, dealing with obvious discrimination such as false gender is often easier to deal with than the more subtle prejudices and microaggressions that often occur. Kennedy. He recalls the case where a technician who saw Olson Kennedys number one surgical scar gave him a heart test, and talked about her opposition to gender-identifying care for transgender adolescents throughout the test. did. Its much harder to handle than if I came in and she gave me a female gender, he said. The difficulty is the emotional and psychological sacrifice of interpreting things.  As LaNae Grant, 37, from East Orange, NJ, experienced, transgender people can face more or less discrimination in the medical setting just by looking. 7 years ago. I hate being able to do certain things that certain transgender women cant do because of the simple fact that they may look different, she said. How can you be prejudiced when you look at a person or body?  All transgender people like Grant who talk about interacting with health care providers point out that they are privileged as transgender people who even have access to health care in the first place. Transgender adults are more likely to be uninsured and report cost-related barriers to health care than cisgender adults, according to an analysis released last year by the Kaiser Family Foundation. , Highly likely to have low income. Transgender care as a serious public health threat  Discrimination faced by transgender people when seeking routine medical care is increasingly taking steps to limit access to gender-affirming care, especially for transgender youth. Against this background. Its still happening as the transgender community continues to grow. The number of gender-verifying surgeries has quadrupled in 14 years, according to a 2018 study published in. Journal of American Medical Association..  Dr. Ian Tong, Chief Medical Officer of Doctor OnDemand and Clinical Associate Professor of Stanford University School of Medicine, has called on the US Centers for Disease Control and Prevention (CDC) to declare transgender care a serious public health threat. Racism earlier this year. In addition to the large data gaps in research that already exist in transgender people, most medical schools now offer three to five hours of education on LGBTQ care, Tong said, and medical students are only clinically competent. He said he needed to be trained instead. However, they are also educated about implicit bias, the idea of identifying stereotypes that can interfere with treatment. According to Tong, more can be done to allow transgender patients to see more doctors who are also transgender.   Transgender and gender non-binary medical students and doctors report a minority and face barriers such as stigma, discrimination and the need to hide their identities during medical education. Transgend health..  Olson Kennedy said not only how many hours of education the care providers are educated, but also what they are taught and how they approach patients (take more time). It is also a problem (including). If what we are doing is training people to act in a particular way and we are not talking to people about changing the actual belief system, we are in a training cycle and the result. No, he said. We need to think about alternatives such as: [doctors] Can interact with [transgender] Man.   For many in the transgender community, gender-verifying physicians can be found through word-of-mouth, online forums, and more recently, companies that connect patients to culturally and clinically competent physicians. Colin Quinn, co-founder and CEO of one such company, Included Health. We often see that we may find a very welcoming and open treatment provider. [transgender] The community may not have the clinical capacity to do so, Quinn said. In certain parts of the country, were hitting our heads against the wall to find a provider.  The coronavirus pandemic has made access to competent medical care in many ways more difficult for transgender people, but has provided a silver backing through rapid adaptation of telemedicine, allowing people regardless of location to be gender Helped to access care to make sure, those who pointed out that telemedicine is not the solution to the barriers facing the community. Leading medical groups, including the American College of Obstetricians and Gynecologists and the American College of Physicians, have recently begun publishing a comprehensive guide to transgender care, from clinical details of gender-verifying care to the treatment of dignified transgender patients. I did. respect. This is important 365 days a year, Freeman said. Transgender people work on this every day.  Copyright  2021, ABC Audio. all rights reserved.