Only 71 percent of transgender patients with self-reported need for care were able to get it in the ER, possibly because of perceptions, discrimination or poor care, according to a study published in Annals of Emergency Medicine.
Twenty-one percent of 433 transgender patients interviewed during 2009-2010 reported they avoided the ER because they thought their trans status would negatively affect their experience. Fifty-two percent said they actually had a negative experience at some point. In addition, more than half of trans patients said they had to educate their providers "some" or a lot" when it came to trans issues, according to the study.
"Patients who have had trans-specific negative experiences in other parts of the health care system may defer care until they are desperate and need the ER," said lead study author Greta Bauer, Ph.D. of the Schulich School of Medicine & Dentistry in London, Ontario, Canada, in an announcement by The American College of Emergency Physicians. "The good news is that nearly three-quarters of those who needed emergency care were able to get it in the ER. The bad news is that so many still were not."
Patients in the study tended to be younger--34 percent ranged in ages of 16-24-years-old--and although the group was balanced in the ratio of male-to-female and female-to-male patients, researchers said female-to-male patients were more likely to visit the ER dressed in their expressed gender identity than male-to-female patients.
Lamda Legal, a non-profit dedicated to fighting for lesbian, gay, bisexual and transgender (LGBT) rights, put together a document of transgender-affirming hospital policies. It suggests organizations:
- Post non-discrimination policies and the patient's bill of rights on hospital websites, in patient waiting areas and employee work areas, and distribute the information to patients and employees during orientation;
- Place a "transgender" option under the gender registration on admission forms; and
- Implement interaction protocols that call for doctors to use patients' preferred pronouns and name, and assign access to restrooms that correspond with the patients' expressed gender identity.
A piece in The Health Care Manager stated the importance of practitioners acting "as guide, protector, and confidant to their patients' most vulnerable healthcare concerns," and to assess their own beliefs and practice habits in order to ensure a supportive environment for LGBT patients, who are often at risk for feeling scrutinized or stigmatized when receiving healthcare, FierceHealthcare previously reported.
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