The issues pervade all elements of care and coverage.
For transgender patients, walking into a doctor’s office or hospital exam room is too often an anxiety-inducing experience. From insurance exclusions to a lack of provider knowledge to outright discrimination, the American healthcare system is stacked against them. Let’s take a look at three of the most urgent areas of concern, and what we can do to help trans patients get the care they need.
1. The Emergency Room Learning Gap
Transgender people are four times more likely to live in poverty than the American population, and 19 percent of trans folks have no health insurance. This means that, in general, they’re unlikely to seek preventative care, instead only seeking medical attention during an emergency.
This has serious implications: transgender people have a higher prevalence of poor general health and are more likely to have had myocardial infarction than cisgender people.
But emergency rooms aren’t always the most hospitable environments for trans patients, and the pace at which they operate often prevents access to detailed medical records. As a result, trans patients are often misgendered, referred to by the wrong name, and even misdiagnosed.
2. A Lack of Knowledgeable Care Providers
Unfortunately, such blind spots are hardly exclusive to emergency rooms: 70 percent of trans patients report encountering some form of discrimination across medical settings, and over half report having to explain trans-specific health issues to their own physicians.
Why are doctors so clueless when it comes to trans-specific health? Because they never learned about it.
A 2011 JAMA study found that most medical schools don’t provide more than five hours of LGBT-specific training over the duration of an entire med school program (typically four to five years of postgraduate training). Five hours isn’t enough time to cover one LGBT-specific healthcare issue, let alone all of them.
The material covered in the meager LGBT-related coursework administered to medical students only reinforces the broad stigma members of the trans community currently face. Most curricula focus narrowly on sexually transmitted infections and H.I.V.
A 2011 report by the Institute of Medicine (IOM) noted that “although LGBT people share with the rest of society the full range of health risks, they also face a profound and poorly understood set of additional health risks due largely to social stigma.”
3. Trans Broken Arm Syndrome
Another harmful way in which physicians fail to properly care for trans patients is known as “trans broken arm syndrome.” This occurs when healthcare providers assume that all medical issues are a result of a person being trans — from a head cold to clinical depression to respiratory issues.
Doctors often assume — inaccurately — that conditions like high blood pressure and high cholesterol are side effects of hormone replacement therapy, even as studies continue to show that hormone therapy programs have no demonstrable effect upon either.
And yet, even as doctors forge unfounded connections between common health issues and trans-related treatments, they remain totally unprepared to address the changes brought on by transition.
Where Do We Go From Here?
While future classes of medical school graduates are more likely to have received thorough training on LGBT-specific health risks, systemic change takes time. In the meantime, it’s incumbent on practicing physicians to educate themselves, ask questions, and take tangible, practical steps to better serve the trans community.
At Lighthouse, our mission is to connect queer patients of all gender identities and sexual orientations with affirming, respectful, and knowledgeable providers. Find a doctor who gets you — make an appointment today.