UMEM Educational Pearls

Title: Experiences of Transgender and Gender Nonbinary Patients in the ED (submitted by Dr. Kyle Fischer)

Category: Misc

Keywords: DEI, transgender, nonbinary (PubMed Search)

Posted: 11/28/2022 by Rachel Wiltjer, DO
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Approximately 1.4 million transgender and gender nonbinary patients live in the United States. Unfortunately, prior research has shown negative experiences with the health system are common after disclosing their trans/NB status. As a result, almost a ¼ report avoiding or delaying needed health care.

This qualitative study interviewed a subset of trans/NB individuals about their experiences visiting emergency departments. Several key themes emerged:

ED intake forms are commonly unequipped to reflect patients’ pronouns and chosen names. This leads to downstream misgendering and the use of deadnames.
Patients often fielded inappropriate questions and comments unrelated to their medical care
Many patients felt they had to educate clinicians regarding issues of trans health, rather than the other way around
These negative experiences decreased the likelihood patients would return for needed medical care

Overall, the study found that clinicians have many opportunities to improve the care of transgender and nonbinary patients, including updating forms, using inclusive language, avoiding medically unnecessary questions, and providing training for staff on trans/NB health.

References

Allison MK, Marshall SA, Stewart G, Joiner M, Nash C, Stewart MK. Experiences of Transgender and Gender Nonbinary Patients in the Emergency Department and Recommendations for Health Care Policy, Education, and Practice. J Emerg Med. 2021 Oct;61(4):396-405. doi: 10.1016/j.jemermed.2021.04.013. Epub 2021 Jun 25. PMID: 34176685; PMCID: PMC8627922.