When my friend and former colleague Beck Bailey was in a skiing accident, he faced a situation that many transgender people dread—he needed emergency medical care and likely hospitalization. He worried about whether he would be treated with respect and dignity, and even whether he would receive appropriate medical care or face discrimination based on his transgender status. This fear of discrimination often leads transgender people to avoid seeking medical care. Beck had no choice.
As he wrote about his experience, beginning on his journey to the hospital and throughout his 15-day stay, Beck was frequently misgendered, or referred to with the wrong pronoun, which is among the most common types of discrimination transgender people face. He also found that many of his caregivers were compassionate and had a true desire to treat him with dignity and respect, yet often didn’t know what that entailed.
Healthcare executives play a vital role in helping caregivers in their healthcare facilities understand how to treat transgender patients with the dignity and respect that all patients deserve. In fact, ACHE’s policy statement, “The Healthcare Executive's Role in Fostering Inclusion of LGBTQ+ Patients and Employees,” calls on healthcare executives to “create a culture that is inclusive and welcoming of the LGBTQ+ community and communicate a zero tolerance for discrimination.” Here are some ways you can help your healthcare organization do that:
- Adopt a transgender-inclusive patient nondiscrimination policy. The policy should state that the term “gender identity and expression” is part of the organization's list of protected classes. While many healthcare facilities have made this update, our research for the Healthcare Equality Index 2022 found that hundreds of hospitals did not have fully LGBTQ+ inclusive nondiscrimination policies. Just having a policy, however, is not enough. Make sure that you are communicating the policy to your patients and staff.
- Adopt policies aimed at eliminating bias and insensitivity. Go beyond your patient nondiscrimination policy and put policies in place that specifically outline procedures and practices aimed at eliminating bias and insensitivity and ensuring appropriate, welcoming interactions with transgender patients. These policies should cover areas such as rooming assignments for transgender patients based on gender identity; protocols for interacting with transgender patients, such as ensuring that staff and providers address patients by the name and pronoun that they use; access to restrooms; and compliance with privacy laws. Sample policies can be found in the guide Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies, from HRC Foundation, Lambda Legal and the LGBT Rights Committee of the New York City Bar Association.
- Capture gender identity, chosen name and pronouns in your electronic medical records. Documentation of both current gender identity and sex assigned at birth is critical for delivering appropriate care to transgender patients. And capturing and displaying both chosen name and pronouns can help providers avoid inadvertently misgendering or deadnaming a patient. While this can be one of the more challenging practices to implement, this guide from the National LGBTQ+ Health Education Center can help you get started.
- Train your staff on transgender-inclusive policies and practices. Make sure all patient-facing staff are provided training on your nondiscrimination policies and protocols as well as gender-affirming communication practices.
This week is Transgender Awareness Week, which is an opportunity to honor and celebrate the transgender community and to raise the visibility of transgender people and the challenges they face. As such, it is the right time for healthcare executives to assess how well their healthcare facility is doing when it comes to creating a welcoming and affirming environment for their transgender patients, so patients like my friend Beck are ensured the dignity and respect they deserve and can focus on their recovery.
Tari Hanneman is the director of the health and aging program at the Human Rights Campaign Foundation, where she oversees the biennial Healthcare Equality Index, which helps healthcare facilities adopt LGBTQ+ inclusive policies and practices. She can be reached at tari.hanneman@hrc.org.