Improving health care encounters and communication with transgender patients

Abstract

Background/objectives

Transgender persons represent a generally ill-served or underserved population. This marginalized group continues to experience considerable difficulty in obtaining culturally competent health care despite recommendations by professional organizations and introduction of antidiscrimination legislation. This review examines communication and procedural barriers to transgender health care and suggests practical steps to help ameliorate disparities and unequal treatment.

Methods

Publications addressing health disparities and communication and procedural barriers to health care of transgender persons were identified by a structured search of electronic databases. The most pertinent articles are reviewed and consolidated with the authors’ collective experiences.

Results

To improve their interactions and communication with transgender persons, health care providers can take a variety of practical steps in several key areas: office environment, registration forms, initial interview and assessment, confidentiality, personnel training, awareness of and compliance with applicable antidiscrimination legislation, health insurance-related issues, and outreach and transgender health promotion.

Conclusions

Enhancing patient satisfaction through culturally competent health care, quality assurance, and patient feedback is critical to creating open lines of communication between practitioner and patient and fostering a favorable context for transgender patient care.

Keywords:

• Transgender
• Cultural competency
• Physician–patient relations
• Affordable Care Act
• Attitudes
• Antidiscrimination laws

Addendum

D Stroumsa recently published an excellent review on transgender US health care policy, law, and medical frameworks in Am J Public Health. 2014 Jan 16 (doi: 10.2105/AJPH.2013.301789).

Author information

Jan Redfern holds a doctorate degree from the University of Sheffield, UK. She completed a research fellowship at Baylor University Medical Center, Dallas and subsequently accepted a position as Research Assistant Professor in the Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas. In 1997, she founded Redfern Strategic Medical Communications, which specializes in developing scientific, medical, and educational materials for healthcare providers. She also serves as an educator for transgender health care-related issues on behalf of VCS Inc, New City, NY.

Bill Sinclair, LCSW, completed his Bachelor of Arts Degree at the University of Dallas and received his Master's Degree in Social Work (MSW) from New York University. Bill also earned a certification in Mental Health Evidence-based Practice from the New York State Office of Mental Health. Bill's clinical work has included ACT Team experience, Wellness-Self Management Group leader in an SRO setting, outpatient substance abuse treatment and most recently four years in a Manhattan psychiatric emergency department. Bill co-authored a paper on implementing Mental Health Evidenced-based Practices and has presented lectures on a variety of topics including interdisciplinary team dynamics, LGBTQ issues and bipolar disorder.