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LGBTQ Issues for Health Professionals

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Zaneta Rago

on 14 October 2015

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Transcript of LGBTQ Issues for Health Professionals

Presented by Zaneta Rago-Craft
LGBTQ Issues for
Healthcare Professionals
Center for Social Justice Education
& LGBT Communities
= Anatomical package (internal/external genitalia, gonads, hormones, chromosomes)

= Self-perception/psychological sense of one’s own gender

Sexual Orientation
= Direction of one’s sexual, emotional, physical attraction for others
Finding a Common Language
Sex Assigned at birth
Attracted to Women
Attracted to Men
Gender Expression/Roles
Sexual Orientation
Gender Variant/
Gender Non-Conforming
Drag Queen/King

Expanding the
Gender Binary
Trans Experiences
Personal Transition:
Coming Out to Self, Defining Authentic Gender Identity and Expression
Social Transition:
Establishing Preferred Name, Preferred Gender Pronoun, Adapting Gender Presentation, Non-Formal Identification (email, shift schedule, nametag, etc), Coming Out to Others
Physical Transition:
Hormones, Gender Reassignment Surgeries, Electrolysis
Legal Transition:
Birth Certificate, Degree/Transcript Information, Drivers License, Social Security Information, Passport, Military ID, Marriage Records, Insurance Documentation, Property Deeds, Financial Accounts, Retirement Accounts, Payroll Information,Business Contacts, Adoption Records and/or Birth Records
Coming Out & Transitioning
Name (Legal vs Real)
Use real name & pronouns when addressing patients
Insurance Claim Processes- Always use legal name
Transition-Related Questions
Hormone Usage (dose strength, brand, prescribing doctor if available)
History of Present Condition
Symptoms, nature and course of present
state, precipitating events, frequency and
DO's & Don'ts
Don't make assumptions about identities!
SRS Surgical History/Status
Surgeon, Date, Procedures
Known complications/current issues
Psychiatric History/Prior Hospitalization
Causes and Length of Care
Sexual History
Family History
Social History
Smoking and alcohol increase
certain risks
Physical Exam
Sex of body important, but should
be addressed with sensitivity

Never disclose a patient’s transgender status to anyone who does not need to know this to provide medical care. Transgender identity should be treated like any other health disclosure and not fodder for office gossip
If possible, provide a patient with a private room during the duration of their stay
Verifying all insurance related administration is adhered to strictly to ensure coverage of services
Ensuring that medication regime is observed, particularly with time sensitive hormones
Partner with other medical and mental health care professionals to ensure that patients receive complete care
Seek out training on transgender related health care issues-attend conferences, workshops, CEU trainings, articles, etc. (Mizzoni/Callen-Lourde)
Taking Histories
Taking Histories Continued
National Transgender
Discrimination Survey

78% of respondents report verbal harassment in K-12 schools, along with 35% physical and 12% sexual- leading 15% to drop out of school before graduation
Double the rate of unemployment, and 4x the rate for transgender people of color
90% experience harassment, mistreatment or discrimination in the job setting and 47% reported adverse job outcome (being fired, not being hired or being denied a promotion)
However, 80% experienced a more satisfying experience in the work environment post-transition, even with the harassment
16% of respondents said un/under-employment led them to engage in an underground economy, such as selling drugs or sex work
53% experienced harassment in a setting of public accommodation
19% had Experienced Homelessness (and 55% who had accessed a shelter reported harassment by facility staff)
30% had experienced police harassment and 48% shared that they would be uncomfortable asking for police assistance
57% experienced significant family rejection
85% higher rate of incarceration
23% had experienced a catastrophic level of discrimination (considered 3 or more of the above)
19% had been refused medical care because they were transgender (and up to 30% for trans people of color)
50% had to teach their medical providers about transgender health issues and care
28% postponed care due to provider discrimination and 48% because of inability to afford services (lack of insurance coverage)
41% of respondents had attempted suicide
Extremely high rates of depression and anxiety, that lead to more complicated mental health concerns and self-harming behaviors
71% tried to hide their gender identity or delayed their transition process to avoid discrimination, resulting in depression and anxiety
4 times the national average for HIV and STIs
Double the national average for misuse of drugs/alcohol and smoking in an effort to cope with discrimination and harassment, causing a variety of physical, sexual and mental health issues
High rates of Injection Silicone Usage (ISU) and Street Hormones, which lead to a variety of health issues: infection, disfigurement, vulnerability to cancer, increased risk for heart disease and blood clots, etc.
Avoidance of restrooms in public spaces, leading to urinary tract infections and permanent harm to the bladder/kidney
Refusal to admit or treat transgender patients
Intrusive and medically unnecessary examinations as a condition of treatment
Refusal to provide transgender patients services that they provide to other patients
Harassment or refusal to respond to harassment by staff or other patients
Refusal to provide counseling, medical advocacy or referrals, or other support services
Isolation or deprivation of human contact, or limiting of participation in social or recreational activities offered to others
Requirement to participate in “conversion therapy” for the purpose of changing your gender identity
Harassment, coercion, intimidation or interference of a trans-person’s ability to freely exercise your health care rights
Know the difference between sex, gender and sexual orientation
Refer to a patient by their real name and gender pronouns. If you aren’t sure what name/gender pronoun a person would like to be called, politely ask them. This is not considered intrusive and
shows the patient that you respect them.
Ensure that intake forms have “chosen name” and “sex" AND "gender” as options for patients
Ensure that any single-stall restrooms are labeled “Unisex” or “Gender Neutral” or "Universal"
Establish an effective policy for addressing discriminatory comments or behavior
Focus on their care and resist the urge to ask questions that are motivated by your curiosity about transgender identity
Avoid asking questions about surgical status and/or genitals unless it is germane to serving the patient’s health related issue

PRONOUNS: She/Her/Hers
Full transcript