Transgender patients in Massachusetts face healthcare barriers

In a state considered on the cutting edge when it comes to healthcare, many transgender patients still find it difficult to access good care in Massachusetts.

Transgender patients say they regularly encounter barriers to care, including outright hostility, in some hospitals and doctors’ offices.

Their stories—a transgender man being turned away at a gynecologist’s office, a doctor in an emergency room who called in colleagues to “take a look at this” and a patient who encountered a registration clerk who loudly insisted the person had to be either male or female—are described in the first report compiled by The Health Equity Roundtable, run by the foundation of health insurer Harvard Pilgrim Health Care.

The program focuses on health disparities and ways the healthcare industry can tackle issues by hearing from individuals directly affected. The Roundtable convened a panel of 35 people, including transgender patients, others who said they have a transgender family member and doctors.

Participants painted a familiar picture when it comes to transgender care: Medical professionals who lack basic knowledge about transgender health issues, a lack of training, few medical providers that specialize in transgender care, long waiting lists for appointments, and few experienced providers outside of Boston’s hub. Multiple surveys have found transgender people often face hostility and ignorance in many doctor's offices and many patients skip medical care because of poor experiences.

The panel recommends some steps to improve care, including educating emergency room staff on basic care for transgender patients and disciplining anyone if poor care or refusal of care is documented. Studies have shown that training is an effective way to ease the stress of medical care for transgender patients. The panel also advocates for insurers to expand coverage to cover the costs for specialty care.