The 2015 U.S. Transgender Survey, published by the National Center for Transgender Equality, for instance, found that a third of trans respondents who’d seen a specialist in the previous year reported a negative experience related to being trans and that 23 percent of respondents had not gone to the doctor when they needed one in the previous year because they feared being mistreated as a trans person. What’s more, healthcare providers are not generally well trained in issues that affect trans patients. A recent nationwide survey of oncologists by the NYU School of Medicine and the Moffitt Cancer Center, for example, found that nearly 83 percent of participants said they felt comfortable treating transgender patients, but only 37 percent said they were adequately trained to do so. How can a trans person screen for healthcare providers and facilities that will be both welcoming and capable of serving their healthcare needs?
1. Ask Around
“If there’s not a trans-specific support group or community, you can try calling the LGBTQ+ support groups and asking if there are any medical providers or specific clinics that have experience with caring for trans-identified people,” says Timothy Cavanaugh, MD, who practices at Thundermist, a Rhode Island–based medical practice with a team of professionals dedicated to serving the healthcare needs of people who are trans.
2. Check With a Few Trusted Sources
Dr. Cavanaugh also suggests checking listservs online and the World Professional Association for Transgender Health, which features a “Find a Provider Section” on its website. The Human Rights Campaign also publishes a Healthcare Equality Index, which ranks health facilities in every state. Scoring criteria include nondiscrimination policies, services, and support as well as employee representation.
3. Look for Signs of Welcome
When at a healthcare facility, look for brochures and educational materials about LGBTQ+ health concerns, LGBTQ+-friendly posters, and a visibly posted nondiscrimination statement, says the American Medical Association (AMA). What does a nondiscrimination statement look like? AMA has a downloadable nondiscrimination policy PDF to give you an idea. Additionally, pay attention to how the staff respects things like preferred pronouns and your name of choice. If you’re being hassled over a discrepancy between the name on your insurance card versus what you’d like to be called, for instance, it’s not a good sign.
4. Check for a Trans Checkbox on the Intake Form
Now that you have settled in the waiting room, play close attention to the forms you’re signing. If there’s more than just the “male” and “female” options on the intake form, it’s a good indicator that the facility thinks about inclusivity. Cavanaugh says to also be on the lookout for members of the LGBTQ+ community working at the healthcare facility. A clinic that’s hiring people who don’t necessarily fit the gender binary can give a sense of how the organization as a whole approaches people who are gender diverse.
5. Extra Points for a Follow-Up Call
Taking the extra step to check in with patients and gauge their feelings post-appointment helps establish a trusting relationship with trans patients. A member of Thundermist’s trans welcoming team always calls new patients after their first visit to make sure their experience was professional and welcoming, to see if they need follow-up appointments, and to let them know about upcoming trans-focused events and resources.
6. Ask Key Questions — And Trust Your Gut
Cavanaugh says it’s important to gauge the provider’s reaction when you ask questions like, “I have some concerns around gender identity and affirming my identity. Is that something you have any experience in or that you’d be comfortable helping me manage and care for?” “It’s a pretty straightforward question,” says Cavanaugh. “If a provider comes right back with a ‘Yep, I’m fine with that’ or ‘I have some experience with that’ or ‘I take care of a number of trans patients,’ that’s great.” If the provider expresses some openness to working with a trans patient, it’s a good sign. They might say something like, “I don’t really know a lot about this yet, but I am certainly willing to work with you and do some of my own reading and research to figure out how to best take care of you.” If the provider becomes flustered, fumbles over words, or can’t really give you good answers to your questions, find someone else, Cavanaugh says.
