How to know if you'll have transgender patients
Creating a business plan for a service line that meets the needs of
transgender patients is not as easy as doing one for, say, cardiovascular or asthma patients. That’s due in large part to a dearth of data on this patient population. Health systems historically haven’t asked patients to identify themselves, and neither does the Census. In 2020, the Census Bureau added a checkbox for same-sex couples living in the same household to identify their relationship to each other, but not gender identity.
It’s even a problem at the Veterans Affairs Department. Although LGBTQ veterans are at risk of higher rates of depression and thoughts of suicide, the VA doesn’t collect data on gender identity or sexual orientation. In 2020 the Government Accountability Office recommended the VA start asking these identifying questions in a systematic way so patients can be screened for risk, and health disparities can be addressed.
In a written response to the GAO report, then-VA Acting Chief of Staff Brooks Tucker said the department was working on improvements in collecting the data as part of its massive electronic health system overhaul.
“We still have this data desert around trans individuals and LGBTQ+ patients that unfortunately has limited some of the development of the provision of care in this area,” said American Medical Association board member Dr. Jesse Ehrenfeld.
But some systems are starting to ask the question. In 2019, North Carolinabased Novant Health started asking patients via their EHR for this data, which had the added benefit of helping clinicians use the correct pronouns for patients and creating a better care experience.
“So rather than a team member using incorrect pronouns, that information is in the medical record, and they can use it. That builds respect and trust between the patient and the caregiver,” said Wendy Renedo, a transcultural health manager at Novant Health.
A good place to start providing an inclusive care environment for transgender patients is with training on the World Professional Association for Transgender Health standards of care to find out what kind of care you might be able to provide, and finding providers who are interested in caring for this population. Eventually, providers might hire a medical director for transgender health as the practice grows.