The American health care system promises equal and nondiscriminatory treatment for all individuals, regardless of their gender identity. Yet transgender patients are all too often wrongly identified, socially ridiculed and often denied medical treatment by their physicians. A report by the National Transgender Discrimination survey found that more than one-third of respondents delayed seeking care because of this discrimination. A report by Lambda Legal increased this estimate to 70 percent. As those who identify as transgender or do not conform to gender norms become more visible, medical institutions and professionals must assure that doctors, nurses and caregivers are equipped with the skills necessary to provide high-quality, equitable health care.
Currently, doctors and health care staff lack the required education and training to give sensitive care to transgender patients. The Society for Academic Emergency Medicine (EM) has found that the vast majority of EM residency programs lack transgender-focused curricula, either in the form of lectures or didactic curriculum. Transgender individuals face worse health outcomes than their non-LGBT counterparts. The U.S. Department of Health and Human Services, reports that transgender people have higher rates of HIV/STDs, victimization, and poor mental health. They are also less likely to have adequate health insurance.
Though the Department of Labor has made progress in prohibiting discrimination against transgender employees, regulations do not change practices -- or health care systems. Institutions should collect robust data on the variability in quality and the impact of health care delivered to people of different sexual orientations and gender identities. By monitoring health care outcomes, evaluating patient experiences, and allowing self-identification for gender, these institutions can change the disheartening health outcomes of transgender patients.
Medical schools, residencies, and continuing medical education programs must actively address transgender health in the classroom. The Association of American Medical Colleges recently released its first roadmap for caring for LGBT persons, or those who are gender nonconforming or born with differences in sex development. This competency-based framework encourages faculty and professionals to include the LGBT communities. By challenging unconscious biases in professionals of all levels, institutions can ensure higher-quality health care in the U.S.
Assuredly, the burden of medical education should not fall on any patient. This past February, the National LGBT Health Education Center announced an online training in transgender health, an innovation medical institutions and professionals can follow. Several medical schools, like Vanderbilt, have added LGBT health to their curriculum, but most others lag behind. The benefit of integrating gender-sensitive education into medical programs trickles down to nurses and college health professionals, who will be equipped to guide transgender youth during hormonal treatment and social transitions. Such changes will help doctors save, improve and treat all lives equally.