What can you do to expand access? First, you must educate yourself and teach others. Many providers report never having received education on LGBTQ health during their training,4 and most barriers for transgender patients stem from this lack of training. Second, work with the transgender community – it is very tempting to see your institution’s name on the HEI and think all the work is done, but the lived experiences of transgender patients sometimes are different than what is seen on paper (or online). Team up with local organizations such as PFLAG (formerly known as Parents and Families of Lesbians and Gays) that can create support groups for both transgender youth and their families. Help create a network of referral systems for your transgender patients – the community is often small enough that they know which providers or establishments are safe for transgender individuals. Many transgender patients find this extremely helpful.5 You still wield significant influence in the community, so work with the health care and insurance systems to improve access and coverage for gender-related services. The HRC HEI is becoming coveted by health care institutions. This is a prime opportunity to be involved in committees seeking to improve health care access for transgender individuals. Finally, as there are champions for transgender health in your clinic, there also are champions for transgender health in insurance companies. They often are well known in the community, so find that individual for counseling on how to navigate the insurance system for your transgender patients.
Although an increasing number of health care institutions and clinics are recognizing the health care needs of transgender patients and providing appropriate care, the health care system remains challenging for transgender individuals to navigate. Small policy changes may have a substantial impact on the health and well-being of transgender individuals. Although creating change within an institution may seem like a monumental task, you do have the agency to help create this type change within the system to expand health care access for transgender patients.
Dr. Gerald Montano
Dr. Montano is an assistant professor of pediatrics at the University of Pittsburgh and an adolescent medicine physician at Children’s Hospital of Pittsburgh of UPMC. Email him at pdnews@mdedge.com.
Resources
- HRC HEI: If you’re interested in learning what policies are inclusive and equitable for LGBT patients, check out the HRC HEI scoring criteria. It’s a good place to start if you want to expand health care access for transgender individuals.
- To find out more about the health care legal protections transgender individuals are entitled to, check out the National Center for Transgender Equality.
References
1. Psychol Bull. 2003 Sep;129(5):674-97.
2. “Injustice at every turn: A report of the National Transgender Discrimination Survey.” (Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011.)
3. J. Adolesc Health. 2018 Apr. doi: 10.1016/j.jadohealth.2018.02.003.