Healthcare & The Transgender Community

By Penda N’diaye
March 29, 2022

International Trans Visibility Day recognizes the trailblazing, courageous voices of Trans people who have moved the needle toward a more progressive and inclusive society for Trans and non-binary people. Their hard-fought activism to live authentically has challenged the world we live in and is slowly shaping a globe that stands in solidarity with sexual and gender identities that have been stigmatized, judged, and ignored. 

Despite this forward movement, there is still an immense amount of violence and discrimination facing the Trans community, particularly Trans women of color, as it pertains to healthcare, housing, and employment. This disparity has become more visible in recent years; in part caused by federal legislation, and bias from healthcare providers. 

According to a study published by the Center of American Progress in 2020, lawmakers at the federal, state, and local levels should enact laws and regulations that prohibit discrimination based on sexual orientation and gender identity in healthcare and reproductive care.

This means not allowing providers to refuse service to Trans and queer people because of their religious or moral beliefs. Many clients and clinicians approach healthcare with their own history and experiences pertaining to sexuality and gender. What’s important here is that those biases don’t interfere with the fair assessment and treatment of any human being.

What Is the Current State of Healthcare for Trans and Non-binary People?

The budding cultural acceptance of Trans identities is a sign of positive change, but with this change also comes a greater demand for healthcare providers who have the right tools to treat and care for patients despite their gender. 

K Health Clinician, Dr. Sarah Malka, explains that a large percentage of trans and non-binary people are hesitant to interface with healthcare because they’re afraid of being treated improperly, or receiving subpar care. 

For example, if a patient’s gender doesn’t match the documentation on record, some clinicians don’t always have the best reactions. Clinicians may ask if a patient has entered their name incorrectly or re-register, immediately excluding the idea that the patient may identify as a gender other than listed on their identification. 

Even worse, healthcare providers may make Trans people uncomfortable by acting if their medical conditions are more complicated than any other person’s. Some providers pathologize Trans and non-binary cases when in actuality it has nothing to do with mental illness but bias and a lack of perspective necessary to treat them effectively. Tran and non-binary identities are vast and nuanced and we should not assume that they equate to a mental disorder without proper diagnoses. 

“Healthcare is where people should have the most positive experience because we as experts on humankind should be the most evolved,” says Malka.

What Can Healthcare Providers Do in Order to Make Trans and Non-binary People Feel More Comfortable?

“First, a hospital needs to decide that it’s important for them to be an inclusive establishment from the get-go,” says Dr. Malka. When a new patient is registered they should have the option to choose their biological sex and then their preferred sex or gender. This practice is neither constricting nor limiting and sets the precedence for future care. Immediate documentation makes it easy for providers to see and understand a patient’s preferences, followed by respect. 

Healthcare providers may need to even go as far as changing their electronic medical records or registration forms to make this information easy to input. Right away providers understand their patients’ pronouns, preferred identity as well as biological sex if it’s medically relevant. 

Healthcare providers need to get on board, enforce non-biased registration and documentation, and lastly, respect each client regardless of gender identity. 

If a provider isn’t aware of the particular nuances within Trans and non-binary communities, they may misinform or worse, harm clients that check off those boxes.

What About the Legislature?

According to the Department of Health and Human Services, in January of 2021, the administration lifted a previous rule that prevented discriminatory healthcare providers from receiving federal funding. This lack of federal protection and the frequent changing of leadership, partnered with human bias, has made it difficult to consistently protect the Trans community. 

A survey, Clinicians’ views on transgender care, reveals, “physician discrimination against the transgender patient population seems to stem more often from a deficit of knowledge than from a deficit of tolerance. Even the most well-intentioned providers may fall short in their ability to provide adequate care to transgender patients without sufficient training in healthcare issues unique to these patients, such as hormone therapy, sex-reassignment surgery, and transition care.”

What’s Next?

There are evolving methods to access healthcare providers that are genuinely interested in fair and unbiased care. Databases like the National Coalition of Sexual Freedom and The Multiplicity of the Erotic conference are advancing sexual and gender diversity and enforcing guidelines for clinical treatment of alternative identities. 

In order to see real change in the healthcare system’s treatment of Trans and non-binary people, we must continue to bridge legislature, federal funding against discrimination, access to insurance, and unbiased care from providers— making safe, thorough healthcare a reality for all.

Penda N’diaye

Penda N'diaye is a pleasure enthusiast who uses storytelling to create playful spaces for conversations on sexual pleasure, arousal and exploration. You find her writing in VICE, goop, Dipsea and Thinx. She is the Founder of Pro Hoe and currently building her own sex toy company.