Two studies which have recently hit the press reinforce a problem I have been considering for some time, namely the difficulties which transgender persons face in getting care. Herein, I will give an overview of these difficulties, the new studies, what they reveal about causes of provider’s behavior with respect to trans persons, and some brief recommendations for how providers can do better.

Transgender health advocates Sabrina Suico of the Couples Health Intervention Project and Brionna of the Mariposa project both work with services dedicated to improving the lives of transgender or gender-variant people of color. Image Credit: Aubrie Abeno, via mintpressnews.com

In 2012, I presented a paper at the American Society for Bioethics and Humanities, “She Walked Out of the Room And Never Came Back…”, in which I discussed the case of a patient who had been denied care by health care personnel while visiting the ER for a broken limb before finally being seen by another provider. The first provider walked out in a huff after the transgender patient’s trans status became clear as the patient’s anatomy was revealed during a diagnostic procedure. After leaving the patient alone, in pain, with no idea whether to leave and go to another facility or wait, another provider came into the room and professionally and compassionately provided the necessary medical care. This, I found, was not uncommon. Approximately 1 in 5 transgender patients have put off preventive medical care due to experiencing, or fear of experiencing, discriminatory behavior directed at the patient by clinical staff. According to some figures, this rises above 1 in 4 (28%), and transgender persons report being denied care across every demographic but worst for transgender women, who were assigned male sex at birth, than for transgender men who were assigned female sex at birth. The fact that transgender persons experience difficulties with access to health care should come as no surprise. In 2011, the Institute of Medicine released a report which addressed the many ways in which poor access to basic medical care for transgender individuals is “due largely to social stigma” and “fear of discrimination in health care settings” as well as lack of employer-provided health insurance due to employment discrimination.