Peeing in A Cup: The Troubling Roots and Consequences of Healthcare Providers’ Ignorance about Transgender Patients


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Image courtesy of Randrenfrow on Flickr

My phone vibrated as I sat in the waiting room. My partner was texting me from the bathroom down the hall at the clinic where I had accompanied her to treat a rash. “I’M TAKING A PREGNANCY TEST. I AM PEEING IN A CUP” she wrote, in a panic. We weren’t worried she was pregnant; however, because my partner doesn’t have a uterus. She is a transgender woman, and her fear, instead, was that her doctor would somehow find out. The doctor had told Hila to take the test before prescribing a cream that could cause birth defects, and Hila hadn’t told the doctor she was trans because she was afraid of the reaction. Doctors and therapists often didn’t know what it meant to be transgender, made Hila feel like a medical oddity, or dismissed every problem she was experience as a symptom of being trans. From my itchy partner’s perspective, treating a simple rash wasn’t worth the risk of disclosing.

My partner’s experiences of poor care are common among transgender people. Half of trans people reported having to teach their medical providers, a fifth said they were refused medical care, 11% were denied therapy, and most disturbingly, a quarter of trans people reported harassment in medical settings.

This poor, unethical, and downright dangerous care is concerning because lifetime experiences of stress and discrimination have caused transgender people to have higher rates of many health issues than the general population. These same health issues are exacerbated by the poor treatment trans people receive. For example, transgender people who are refused treatment by a provider experience an increase in the lifetime rate of suicide attempts from 41%–already shockingly high—to 60% of the transgender population. Further, the poor experiences that transgender clients have with providers can deter them from seeking care in the future. In one study, a quarter of trans people reported postponing medical care. In another, 43% of LGBT clients who had unhelpful experiences in therapy reported diminished quality of life and a quarter developed a negative impression of therapy in general. Health professionals are therefore complicit in worsening transgender health disparities.spaceball

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Image courtesy Marlan on Flickr

Yet at the root of providers’ incompetence and hostility toward transgender people is ignorance. More than half of health care organizations do not require employees to take cultural competency training that includes LGBT issues and 41% of social work program stated that their programs trained students “slightly well” to “not at all well”  when it comes to providing services to all LGBT individuals. Data on trans people, specifically, is unavailable, as trans people are often overlooked in research. No wonder trans people like my partner educate their providers—no one else has.

Trans Health Resources On and Off Campus

Check out this page for more information about how Campus Health Services supports trans health needs. The UNC LGBTQ Center is another resource to support students in navigating trans healthcare on campus. Finally, the LGBT Centers of Durham and Raleigh each keep a listing of community resources that are supportive of LGBTQ people. See the Durham LGBT Center’s listings here, the Raleigh LGBT Center’s community listings here, and the Raleigh center’s list of mental health practitioners here.

By: Anole Halper

Anole Halper is an intern with Student Wellness over the summer.  They are getting a dual Masters in social work and public health.  Their research interests include sexual violence prevention and LGBTQ health equity issues.

 

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