Transgender Patient Preferences When Discussing Gender in Health Care Settings

Transgender Patient Preferences When Discussing Gender in Health Care Settings

By: Alexandra de Leon Date: March 4th, 2024

Gender-affirming health care improves the wellbeing of transgender (trans) individuals. But today, many trans patients frequently report discriminatory and harmful experiences in health care settings.

In a new study published in JAMA Network | Open, researchers identify factors influencing trans patients’ decision-making regarding sharing gender-related information with their providers and their preferences for gender-related questions. Researchers interviewed 27 trans and/or nonbinary adults from across 13 states.

Four themes were identified:

1. Impact of provider behaviors – This includes a level of flexibility in care and interpersonal interactions, the provider’s ability to explain medical relevance of gender-related questions, and preparedness to work with trans patients

2. Engaging in relational risk assessment – Patients would consider implicit or explicit safety cues when deciding how or if to share info with providers, directly related to power imbalances between patients and the providers

3. Receiving affirming vs medically competent care – Many shared when it comes to affirming or medically competent care, they have to prioritize one over the other

4. “How are you going to fit [me] into your system?” – Patients from the study found their needs were at odds with health care system norms and standards of care.

The study found that equitable, gender-affirming, and competent health care requires flexibility and responsiveness to the unique needs of the trans community.

“Provider humility and engagement, as well as institutional policies that support competent and gender-affirming spaces are needed. Providers, administrators, and systems all need to play a role in ensuring competent care for trans patients,” says lead author, Dr. Vern Harner.

This study also underscores existing scholarship, finding that trans health care will require multilevel interventions specific to providers and on an organizational level to advance health justice for the trans community.

Researchers on this study represent the School of Social Work and Criminal Justice at the University of Washington, Tacoma; the School of Social Work at the University of Washington; and the Graduate School of Social Work at the University of Denver, Colorado.