The word ‘transgender’ refers to a person whose gender expression or identity differs from that which was assigned at birth. Transgender individuals face widespread economic and social marginalization. Intriguingly, discrimination, harassment, and rejection ensue even from the healthcare sector, which ranges from routine check-ups, and emergency room visits to mental and medical health services. This paper aims to discuss on the challenges in healthcare that this ostracized community faces, how the challenges affect their overall health outcome, and ways through which they can be mitigated.
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Challenges Transgender Patients Face Within Healthcare
Previous research indicates that in the medical community, this marginalized group faces barriers to accessing quality and affordable healthcare (James et al., 2016). These barriers include inadequate insurance coverage, discomfort and inexperience among health providers in handling transgender individuals, and mistreatment by healthcare personnel. These obstacles make it challenging for transgender people to seek care that is either related or unrelated to their gender transition. Transition-related care comprises several treatments, for instance, hormone therapy, counseling, and surgical procedures. However, although not every transgender individual requires medical care that is associated with their transition status, many need particular interventions that vary with their individualized needs.
Many health insurance coverage plains are unable to include gender affirmation surgery, cross-sex hormone therapy and gender dysphoria costs (Safer et al., 2016). These insurance barriers exist regardless of evidence illustrating the safety and effectiveness of such treatments, and that gender identity and cross-gender matters are not a subject of choice for the individual. Presently, the transgender people are still advocating for affordable health services in spite of the Affordable Care Act forbidding most insurance companies – including those with federal funding – from denying coverage based on health history or gender (James et al., 2016). However, most health insurance plans fail to explicitly cover the cost unique medical treatments required by transgender people.
Lastly, most transgender people delay or avoid seeking medical care as they face discrimination and misunderstanding from health providers. Nevertheless, when they do seek care, they find it challenging to locate a provider with expertise in patient-centered care for transgender people. One study revealed that 50% of transgender individuals felt like they needed to teach medical practitioners about transgender care (James et al., 2016).
How Discrimination from Healthcare Providers Impact the Transgender Community
Populations that are faced with widespread discrimination and stigmatization are more prone to be characterized by poor general health; hence more susceptible to a range of physical and mental health conditions. Studies have demonstrated the presence of a significant amount of health disparities affecting transgender individuals, and the effect that discrimination and stigmatization have on these disparities and access to appropriate care. The after effect for avoidance and inadequate treatment is significant. For instance, the prevalence of suicidal thoughts and behavior among transgender people is significantly higher as compared to that of the general U.S. population. According to James et al. (2016), 40% of the participants in the study reported to have attempted suicide at a specific time in their life, compared to that of the U.S. population which was 4.6%. Moreover, in comparison with non-transgender persons, transgender people suffer from significantly high rates of anxiety, depression, somatization, and general psychological distress. These mental outcomes are a manifestation of enacted and felt stigma and gender dysphoria.
Ultimately, due to psychological distress, transgender persons may resort to substance abuse. The incidence of substance abuse 2.5-4 times higher among transgender adolescents than that of their peers. Transgender youths are also at a higher risk for the early age of onset of substance abuse (Day, Fish, Perez-Brumer, Hatzenbuehler, & Russell, 2017). Moreover, 50% of transgender people have used injectable hormones that did not fall within the conventional medical settings or obtained illegally to spur feminine or masculine psychological changes (Safer et al., 2016).
Mitigating and Preventing Transgender Discrimination in Healthcare
Healthcare facilities can implement several strategies to improve care for transgender persons and create a welcoming environment. These strategies will require the participation of all members of the healthcare team ranging from front-desk staff to medical practitioners and the government. For instance, the U.S. government should create policies that ensure that both federal and private health insurance providers cover the cost of treatment required by transgender people. Additionally, hospitals should create departments focused on transgender medicine; therefore, they should train their surgeons and psychologists in areas of conducting gender reassignment surgeries, and mental health, respectively.
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Discomfort experienced by healthcare providers when treating transgender persons may lead to the delivery of low-quality care. Therefore, resources should be put in place to enable the delivery of culturally competent care to transgender patients. Effective communication tools should be integrated in handling transgender patients, and they will be based on the principles of respect, responsiveness and being welcoming. For instance, a ‘transgender’ option should be added to checkboxes on patient health records; transgender patients should be addressed in their preferred names and pronouns; framing of questions in a manner that does not make any assumptions regarding gender identity or behaviour; healthcare organizations should include ‘gender identity and expression’ in non-discriminatory policies; and facilities should train staff on delivering patient-centered care for transgender people (Centers for Disease Control, 2019).
With the advancement of time, the population of people in the transgender community will definitely increase. Therefore, there is need to create a wholesome and patient-centered care that is independent of discrimination regardless of gender. Access to healthcare is a right for all, and so should transgender people be equally given the proper and quality care they are entitled to.
Centers for Disease Control. (2019). Patient-centered care for transgender people: recommended practices for health care settings. Web.
Day, K., Fish, J., Perez-Brumer, A., Hatzenbuehler, M., & Russell, S. (2017). Transgender youth substance use disparities: Results from a population-based sample. Journal of Adolescent Health, 61(6), 729-735. Web.
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The report of the 2015 U.S. transgender survey. Washington, DC: National Center for Transgender Equality.
Safer, J. D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J. (2016). Barriers to healthcare for transgender individuals. Current opinion in endocrinology, diabetes, and obesity, 23(2), 168-171. Web.