LGBTQ Health Equity Series: Understanding Transgender Healthcare Access & The Patient Experience

CVS Health and Accenture are proud to present an in-depth conversation on transgender health care, alongside a toolkit (to be found at https://cvs.co/3Bsz4ji) of guidance and resources to improve the transgender patient experience.

Part of our ongoing speaker series focusing on LGBTQ+ Health Equity, the goal of this panel is to provide increased awareness and understanding of the transgender patient journey, to explore ways to improve transgender patient access to health care, and to facilitate positive experiences for transgender patients and health care providers.

The 'Pronoun Go 'Round': Our Changing Language Around Gender

How we define gender is shifting, and so is the way we talk about it. Most notably, the way we use gender pronouns. For example, he/him for a man, she/her for a woman or they/them for someone who doesn’t identify with either gender. It’s a change that has come easy for some, but for many people it’s an adjustment that can be anxiety-inducing as they worry about saying the wrong thing. And then there are still others who simply don’t get why there is a need for a change.

Under the Radar with Callie Crossley, November 13, 2018

Supporting Transgender Patients Today and Everyday

A note to the LGBTQ and Allies of Harvard Medical School:

Today is a hard day for our community and families. Yesterday, the New York Times reported that the current federal administration was: “considering narrowly defining gender as a biological, immutable condition determined by genitalia at birth, the most drastic move yet in a governmentwide effort to roll back recognition and protections of transgender people under federal civil rights law.”

We know that the sex we are assigned at birth and our gender identity are not the same. We can’t exam a baby at birth and project the life they will live, who they will love, and how they will come to see themselves.

In every corner of the HMS system, I am inspired by the providers who are taking care of transgender, nonbinary, and gender nonconforming patients with sensitivity and respect. Many of you have announced this care with your websites, rainbow stickers, and the forms in your office. Some of you are doing this quietly with no other support, just approaching each person with openness and care knowing everyone has a rich and meaningful story to tell you.

Historian Joanne Meyerowitz, in her award-winning book: “How Sex Changed”, describes that throughout history, individuals expressed genders that were different from sex. And by the 1950s, even American doctors decided this distinction was medically sound. "They distinguished biological sex from the sense of a sexed self, which they labelled "psychological sex" and later "gender". They began identifying component parts of gender, distinguishing gender role from gender identity, and also separating gender from sexuality." 

So, doctors created this distinction as a way to understand people. It wasn’t what they could see in a microscope or brain scan, but what they saw in their patients. Just like you are doing today. 

Today, the Class of 2022 of HMS medical students is nearly 20% LGBTQ and many embracing a nonbinary identity. Many more on top of that percentage are here to carve out a career that cares for transgender patients. I am not afraid by the latest from this current administration because I get to support you all in your work. I know today you will approach each patient with a little more care and curiosity. You remain a vital bulwark against the hardships faced by transgender, nonbinary, and gender nonconforming patients. I’m proud to stand with you. 

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How Should Physicians Refer When Referral Options Are Limited for Transgender Patients?

Transgender people encounter many barriers to health care, and recommendations about where their treatment would best be offered can promote or thwart good care. This case examines the care setting from the perspective of a patient whose experiences with specialists have been negative. We argue that an ethos of harm reduction and informed consent, with a strong emphasis on continuity of care within a primary care setting, should guide questions about how to refer transgender patients to caregivers and to good care settings.