From the website portal and marketing materials to the language practitioners use during appointments, there are many factors that make up a positive healthcare journey. Patient experience can impact what they share with providers and how often they seek out medical care. This is especially true for transgender, gender nonconforming and nonbinary individuals (TGNCNB).
A community with a history of harm by the medical field, many transgender individuals rightfully fear medical care and avoid medical spaces. Their skepticism is not just historical or hypothetical, but the result of lived experiences with medical professionals. It’s crucial that medical professionals approach TGNCNB patients with empathy and understanding. Many of these patients have medical trauma. While one positive experience in a medical setting might not negate all the bad ones, every affirming experience is an opportunity to rebuild trust between TGNCNB patients and medical systems.
Remote healthcare services offer TGNCNB patients greater agency in a number of ways. By choosing where and when to take appointments, they can select locations where they are most likely to remain comfortable and safe. Patients can also speak camera-off, mute quickly, or even end appointments at the push of a button – all small but critical ways to ensure greater control over their care experiences.
In addition, telehealth appointments can connect patients to greater networks of affirming medical staff, further minimizing the potential for harmful or dangerous interactions. For example, people on gender-affirming hormones can meet providers virtually and have prescriptions delivered at home to avoid hospitals or pharmacies where they feel unsafe.
While there is no way to achieve gender competence, there are many ways care providers, both virtual and in person, can be gender-affirming. What every person finds affirming is unique and specific to them! Knowing a patient holistically is the best way to ensure that they have a positive experience. (This is a practice that benefits not just TGNCNB, but all patients.)
When providers begin to consider gender affirming practices, it is good to start by thinking through the patient journey. Patients start by reviewing a website to determine if they’d feel welcome in a healthcare space. If a practice uses a lot of gendered language like “services for men and women” or “his/her appointment,” someone who does not identify as a man or woman or someone who uses a different pronoun set/multiple pronoun sets might not feel safe. Could that person still have an affirming experience with that provider? The goal is for patients to feel supported and actively considered through every step of the appointment process.
Similarly, with intake forms, the questions you ask and the options you provide for patients say a lot about your diversity and inclusion practices. Best practices often depend on the context of the intake questions, as well as what information is medically necessary. Be clear with patients about what you mean when you use the word gender, as gender and sex, as well as sex assigned at birth are often conflated. This can be confusing for patients, and even lead to incorrect responses — or responses that will lead to difficulty for the patient later. For example, if a patient needs a hormone panel completed, someone who identifies as trans would be confused by “male” and “female” as options for “gender.” Was this question really asking for sex assigned at birth? Legal sex?
Check out Beyond the Binary: 5 steps to designing gender inclusive fields in your product for more information on how to assess context and best practices for gender options and fields.
In addition to the language present on websites and intake forms, the language practitioners use during in-person and virtual appointments is a great place to model gender inclusivity. People use many different terms to refer to their body parts. It might not always be possible to include every word that would be affirming for patients, but it helps to model many different terms for body parts. Hearing medical professionals acknowledge this point can be incredibly validating and healing for transgender, gender nonconforming and nonbinary individuals. Language — TransHub and Trans-Affirming Clinical Language are amazing resources that model how to talk about bodies and how to create space for patients to share the language they use for their bodies.
One of the recommendations is to use gender neutral language as often as possible. For example, instead of saying “breastfeeding” say “chest feeding” because it is inclusive of more bodies. The word “breast” might feel gendered or painful for some patients. Use the terms interchangeably, making it clear to patients that you will adjust and use just the language that feels best for them.
In situations where specific language is necessary (such as collecting data for a lab system or type of test that requires specific inputs and has set fields) it can be helpful to explain WHY you are using that language to patients. Language — TransHub has a great template for sharing with patients the language you will be using and why. This relays to patients that you have thought about them and acknowledged potential limitations in your system. By acknowledging potential harm, you show patients that you care about them feeling affirmed in your space.
Ash Wellness is dedicated to supporting our TGNCNB end-users. Set up a time to chat to learn more about how we can help your patients and customers.