August 14, 2013

New Study Exposes Trans Stigma in Health Care

A new report published recently sheds some light on the negative healthcare experiences of transgender patients. 

The aim of Transgender Patient Perceptions of Stigma in Health Care Contexts by Kosenko et al, (Medical Care 51.9, 2013) was to collect and begin to quantify the anecdotes we’ve all heard about or the experiences we’ve shared: mistreatment by doctors, nurses, and other medical professionals when we seek services. As the study notes:

Transgender individuals face social sanctions, including violence and discrimination, for violating prescribed gender norms. The stigma and isolation they experience heightens their risk for mental health problems, such as depression, anxiety, posttraumatic stress disorder, and substance abuse.

Despite these health concerns, some transgender individuals hesitate to seek care for fear of being mistreated by health care providers. Although few studies focus specifically on this issue, several mention problematic interactions with providers and their negative impact on transgender patients. […] Participants in these and other studies report discriminatory and insensitive treatment from some health care providers, yet little is known about the specific provider behaviors deemed problematic.

Thus, the study went out and collected experiences from 152 transgender individuals (mostly from the United States, largely transsexual). They then classified and ranked the resulting responses into six categories, including gender insensitivity, such as misgendering (the most common at 31%); displays of discomfort during exams or visits; outright denial of services (a depressing 20%); substandard care; verbal abuse; and lastly forced care, such as demanding a transgender patient seek psychiatric care before they receive medical treatment (the least common, at 5%). 

The study is quick to note that some of these reports, such as displays of discomfort, could easily be the result of patients misinterpreting ambiguous or neutral behaviors. Likewise, these are all patient anecdotes; there’s no way to know the intentions of the doctors and nurses. .Even so, the authors conclude, 

Despite its limitations, this study gave voice to a group who has been historically marginalized and silenced. This study also produced specific examples of provider behaviors perceived as insensitive by transgender patients. We hope these examples offer providers further guidance with respect to specific behaviors to avoid when interacting with individuals who identify as transgender.

I think we can all agree with those conclusions. 

Has anyone out there experienced gender insensitivity, denial of service, or some other negative experience when seeking out healthcare? I’d like to try an experiment. If you’ve had a specific negative experience with a health care provider, please share it with Transgender Science by sending me an Ask (Use the “Got a Question?” button to the right). I’ve enabled Anonymous submission. I would like to (1) share some of your stories on the blog and (2) maybe quantify our own stories as they relate to the six categories above, 

Big thanks to August P for his help with this article! 

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