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Best Practices

Learn about best practices and providing trans-affirming care across medical disciplines.

Many in the medical community are uninformed about transgender health care or even display outright transphobia. Some lack understanding regarding gender and sexuality. Sadly, there are also medical and mental health providers who are hostile to TGNC patients (ex. An inpatient psychiatric unit refusing to provide feminine hygiene products to someone because they identify as a trans man).

  • Only recently have mental health training programs begun to include affirming didactic and clinical training about sexual orientation and gender identity formation.
  • The job of the mental health professional is to recognize when these disservices exist and attempt to educate other providers who might be treating our TGNC patients.
  • Advocate that health care providers use correct pronouns and focus on the problem that brought the patient to the hospital, emergency room, or clinic.
  • Prejudicial attitudes or fear of making a mistake with pronouns may lead some health care providers to overlook or even refuse to treat TGNC patients.
  • All staff should be trained to respect a person’s pronoun and name choice. All patients should receive this basic level of respect without exception.
  • As clinicians start to see more TGNC patients, it’s important they pay attention to their countertransference. Continue to learn but if you aren’t in a place to provide trans-affirming care, consider a referral to an LGBTQ expert.

Outpatient

  • Simple changes in record keeping can alert both clinicians and staff to the pronouns and appropriate name of a patient while separately noting how to bill insurance.
  • Attempt to make supportive group therapy available that is gender-specific.
  • Gender-affirming therapy should be taught to all staff.

Inpatient

  • All medical and psychiatric inpatient units should be encouraged to place TGNC patients in gender-appropriate rooms and/or single-occupancy rooms if available. Staff should be reminded of patients’ pronouns and be expected to use appropriate names.
  • Experts in the LGBTQ field have noted that some inpatient units have a tendency to uniformly stop cross-gender hormones upon admission, believing that they are the cause of a medical or psychiatric problem. Health care providers should be educated on the risks and benefits of hormone treatment, and hormones should only be stopped if they are doing harm to the patient.

Emergency Department (ED)

  • The emergency department and inpatient units can be particularly traumatizing. When patients are most in need of care, they can become victims of the uninformed clinician (e,g, refusing to treat testicular torsion in a woman of trans experience).
  • It is important that ED staff remain focused on treating the patient’s emergency medical or mental health issue (ex. A person of trans experience presenting for myocardial infarction is questioned about their gender identity history instead of the presenting pain).

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