For the most part, gynecology and obstetrics has been considered strictly “women’s health.” In fact, for a long time, ob/gyns risked losing their licenses if they treated men. In truth, women’s health is human health. The American College of Obstetricians and Gynecologists (ACOG) has recently updated their resources to reflect this. Gender identity is separate from assigned sex, and shouldn’t affect access to medical care.
Our broadening understanding of gender and gender identity means that we need to rethink the idea of what “women’s health” is. At Higher Ground Women’s Health, we take a holistic approach to healthcare. In particular, that means understanding and emphasizing the importance of inclusive practices for trans patients in healthcare.
In the United States, approximately 1.4 million adults identify as transgender, and about 1 in 10 teens consider themselves to be gender-diverse. However, only one-third of gynecologists feel comfortable working with these patients. That represents a huge gap in the need for compassionate, representative healthcare.
While gender norms are pervasive, the field of women’s health has been sluggish to update their practices for an increasingly diverse population. A team of researchers notes in Beyond Women’s Health that “solely referencing cisgender women in the context of sexual and reproductive health — particularly pregnancy planning and care — excludes a diverse group of transgender and gender nonbinary people who have sexual and reproductive health needs and experiences that can be similar to but also unique from those of cisgender women.”
Patient comfort is a worthy concern in and of itself, but lack of inclusion in medical offices creates other barriers to wellness. In their handbook, Providing Transgender-Inclusive Healthcare Services, Planned Parenthood outlines several challenges facing the transgender and gender-diverse community, including:
Changing the language we use in our healthcare practices may be the simplest and most pervasive change providers can make.
Using inclusive language is critically important to creating a welcoming environment. Doing this in a primary care setting can help establish your practice as a safe space. In addition to making an effort to use inclusive language, doctors should educate themselves on the unique needs of transgender patients.
Don’t underestimate the impact of kindness. Many patients — both in and outside of the LGBTQ+ community — have had difficulties with health care professionals. Transgender and non-binary patients may feel so uncomfortable with the health care system that they avoid going to the doctor altogether. This effectively bars a large percentage of the gender-diverse community from preventive and routine care.
Creating inclusive practices for trans patients and non-binary people isn’t a nice-to-have. It’s a must-have. These practices make it easier for people of all genders to comfortably receive the care they deserve.
Take a look at your practice’s forms. Where have you fallen into the practice of using gendered language? Do you ask questions that specifically reference gender identity? Is it necessary?
Consider revising your forms to include more open-ended questions. Instead of asking “male or female?” offer a space for people to indicate their gender and pronouns. Allow them to fill in a name that they’d rather go by, in case it doesn’t match the legal name on their insurance policy.
Finally, take a look at your website, marketing materials, and social media. Does your copy and imagery feel welcoming? The image, tone, and content you use are designed to speak volumes about your brand. If you make an effort to use gender-neutral language, it communicates thoughtfulness and compassion — exactly what your patients are looking for.
When it comes to providing inclusive care, it’s a good idea to assume as little as possible. A person’s gender identity doesn’t indicate their sexual orientation — and vice versa. Take the time to educate yourself and your team on gender-expansive language. Familiarize yourself with the words cis-gender, transgender, and gender non-conforming.
Asking someone for their pronouns — and providing your own — is a good habit to get into. But if you make a mistake? It’s okay. If you accidentally use the wrong pronoun, correct yourself and move on. The effort you make makes all the difference.
Depending on your background, you may have a lot to learn about gender expression and how to develop inclusive policies. It’s okay to admit you don’t know everything. For most patients — regardless of demographic — the most important thing is to build a relationship with healthcare providers you trust.
Your role as a provider is to do your best to provide excellent medical care in an inclusive environment. Use your best judgment and resources to your benefit. There are several resources available on the AGOG website designed to help providers work with the gender-diverse and transgender community.
Everyone deserves a doctor that will listen to them and treat them with respect — regardless of that person’s gender identity. Developing inclusive practices for trans patients will go a long way to ensuring that every single person has access to the care they trust.