Introduction
Differences in appearance or behavior may set forth barriers to effective communication within many spheres. In healthcare setting not putting effort into ensuring diverse patient groups being treated with professional finesse with no regard for their differences is a timely issue. Transgender patients are among those vulnerable communities who are still pressured by the people with excessively traditional views on gender and sexuality. Such bias can contribute to creating an unhealthy work environment in the spheres where personal approach and relationships between a service provider and a client are of grave importance. Healthcare being one of such spheres, therefore, needs a revision regarding practices and philosophy that concern transgender treatment.
Challenges for Transgender Patients
Transgender are the people with their gender identity diverging from the sex attributes defined at birth. Their physiological attunement with one or another gender makes it harder for them to fit in the society where gender roles are generally defined at birth and do not change with time. Knowledge of the healthcare needs of such patients is one of the gravest matters in the sphere (Snelgrove, Jasudavisius, Rowe, Head, & Bauer, 2012). Care providers are often unaware of proper ways or approaches to the treatment of such patients, which leads to poor care satisfaction levels and health outcomes. Transgender patients also face difficulties with being committed to patient wards according to their physical and not self-defined gender. Often, a complex understanding of such sensitive topic that needs to be carefully examined and considered by physicians and nurses is disregarded.
Even organizations that proclaim orientation for diversity and patient-centered care sometimes face issues with treating trans patients (Snelgrove et al., 2012). Sex reassignment surgery (SRS) being often unavailable to patients that feel different about their gender is another issue that needs to be addressed. Not all states allocate enough finances to satisfy the need for such services. The lack of attention towards this problem is probably caused by the statistical insignificance of this group of the underprivileged population. However, a truly caring nation that proclaims tolerance as one of its key values cannot allow forgetting about trans patients despite they represent a small amount of population.
The attitude of healthcare professionals changes over time and start to shift from homophobic and transphobic views to a more open and universally-positive attitude (Dorsen, 2012). Nonetheless, Yen et al. (2007) argue that according to self-reported data, 100% heterosexual people sometimes exhibit intolerance to the LGBT community in healthcare. Highly religious nurses and physicians also show less tolerance towards these groups of patients. Being diagnosed with gender identity disorder (GID) according to Diagnostic and Statistical Manual of Mental Disorders (DSM) seems to be somewhat imprecise and does not consider healthy transgenderism that cannot be associated with other mental issues (Snelgrove et al., 2012). This problem may invoke errors in diagnosis and treatment, which may produce unhealthy outcomes for trans patients. The lack of training among medical staff is also considered as a healthcare-related barrier for successful interactions of the transgender patients with the healthcare system as a whole. Ethical codes and accepted practices seem to be outdated and cannot serve as a clear guideline for trans patient handling.
Implications for Transgender Community
Occurrences of poor service provided at hospitals and clinics have a direct influence on transgender community forming a negative attitude towards healthcare system and government. A general disbelief in the adequacy of care providers can generate a feeling of resentment towards healthcare institutions and result in fewer occasions of seeking medical assistance. Those unhealthy views may negatively affect health and well-being of transgender individuals within the community. It could also lead to the emergence of unorthodox self-treatment practices that could further damage the community’s health. The perceived disregard of the state towards the healthcare needs of the transgender community can produce anti-governmental views that can be hard to avert. A failure of the country and its health system to provide care for each and every citizen may negatively impact their image. The restoration of the good faith in health services may incur high economic costs. Additionally, the transgender community may also consider moving to more tolerant countries, which can become a great scandal.
Tackling the Issue
The challenges that transgender patients experience daily need to be addressed not only to raise the quality of care for this population but also to promote a more well-round and advanced view of medicine in the country. For these purposes, a few improvement options can be proposed. Since many issues arise from the inadequate level of knowledge, certain changes need to be made in the sphere of professional education. Approaches to assessment, treatment, and communication may immensely improve the quality of care and health outcomes for trans patients.
World Professional Association for Transgender Health (WPATH) provides a guideline for healthcare professionals in that sphere creating a new standard of care for transgender patients (Dorsen, 2012). In addition, a campaign for a proper amount of state funds to be allocated to SRS needs to be launched to ensure each person has a right to change an assigned gender and become their true self without feeling any discomfort or discrimination. Psychological evaluation of trans patients needs new models in order to be able to clearly define the nature and the cause of the mental condition in them.
The inclusion of trans patients into healthcare system can be facilitated by creating a friendlier environment in waiting rooms as suggested by Redfern and Sinclair (2014). Health education within the transgender community can also result in better attitudes towards the healthcare system. Outreach strategies that involve promoting healthy practices, teaching proper hygiene, hormone therapy and raising awareness of other transgender-specific issues by professional can generate mutual trust and respect. Such outreach needs to be held by highly skilled professionals that practice non-offensive health education and have an open mind about LGBT society. The process may proceed even smoother if members of the transgender community with a medicine-related degree are involved.
Discrimination in the hospital setting is a serious issue that needs to be tackled through proper communication. For instance, letting patients use and be addressed by their chosen name is an essential part of establishing good-natured relationships between care providers and trans patients. Redfern and Sinclair (2014) also suggest that physical condition of a patient needs to be examined only after ensuring a compliance and psychological readiness of a patient, as this matter is extremely sensitive for transsexuals.
Conclusion
All things considered, healthcare system needs to work further on enhancing its inclusion of minorities. Transgender patients as one of these vulnerable groups need special attitude, which is rarely seen in the clinical setting. Educational measures among the staff, community outreach, better SRS financing, and establishment of proper treatment guidelines and ethical codes could change the views of the transgender community on healthcare for the better and ensure safer environment and quality of care.
References
Dorsen, C. (2012). An integrative review of nurse attitudes towards lesbian, gay, bisexual, and transgender patients. CJNR (Canadian Journal of Nursing Research), 44(3), 18-43.
Redfern, J. S., & Sinclair, B. (2014). Improving health care encounters and communication with transgender patients. Journal of Communication in Healthcare, 7(1), 25-40.
Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer, G. R. (2012). “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Services Research, 12(1), 110-118.
Yen, C. F., Pan, S. M., Hou, S. Y., Liu, H. C., Wu, S. J., Yang, W. C., & Yang, H. H. (2007). Attitudes toward gay men and lesbians and related factors among nurses in Southern Taiwan. Public Health, 121(1), 73-79.