Familiarity with cultural milestones can be reassuring to patients, but Sherry P. Katz-Bearnot, MD, assistant clinical professor of psychiatry at Columbia University, cautioned that there is counterproductive underside to cultural competence. While recognizing the significance of cultural milestones, such as a bar mitvah or quinceañera, can be reassuring to patients, Dr. Katz-Bearnot emphasized that clinicians must remain sensitive to the personal responses to those events.
“If you know too much, there is a risk of glossing over the issues unique to the individual in front of you,” Dr. Katz-Bearnot said. She emphasized that those cultural landmarks do not necessarily mean the same thing to all members of a community. Sensitivity to personal issues trumps cultural familiarity.
The same statement could be made for delivering care to transgender patients, judging from a presentation by Courtney Saw, MD, a PGY3 resident in the department of psychiatry at the University of Pennsylvania, Philadelphia. Quoting a survey that found most transgender individuals consider health care professionals inadequately trained to manage their health issues, she stressed the importance of how questions are phrased.
“Every patient’s gender journey is unique,” Dr. Saw said. For example, specific questions about gender anatomy should be supplanted by open questions about gender transition, allowing patients to respond at their own level of comfort. This, according to Dr. Saw, is essential for “building a therapeutic collaboration.”