National survey shows widespread bias in trans health care

Transgender and gender non-conforming people face rampant discrimination in health care settings and are regularly denied needed care, according to a report released jointly Oct. 13 by the National Gay and Lesbian Task Force and the National Center for Transgender Equality.
The National Transgender Discrimination Survey: Report on Health and Health Care compiled data received by 6,450 respondents from all 50 states. It is, according to the two agencies, the most extensive survey of transgender discrimination ever undertaken. And the results are harrowing.
"It is outrageous that basic health care is being denied to transgender and gender non-conforming people and that so much additional trauma is being caused by doctors instead of being resolved by doctors," said Task Force Executive Director Rea Carey. "The medical profession must take these data seriously and ensure that everyone in the medical care system knows how to provide transgender-sensitive medical care."
Most discouraging is the fact that nearly one in five respondents reported being refused care outright because they were transgender or gender non-conforming.
Transgender Michigan Executive Director and founder Rachel Crandall confirmed the findings. "I know a person who told their story to a physician and the physician said, 'You have 30 seconds to get out of my office before I call the police,'" she said.
Crandall, who is a psychotherapist and gender identity specialist, weighed in on key findings of the national report, including the fact that 50 percent of respondents reported a significant lack of provider knowledge and said that they actually had to teach their providers about transgender care.
"Actually, I think the number of people who have had to educate their health care provider is much higher," Crandall said. "Almost every transgender person I work with has had to do that.
"In med school, there is absolutely nothing taught regarding the trans community," Crandall continued. "That's a problem right from the start. People are learning absolutely nothing in med school, so how can we expect they'll know anything when they get out of med school? I think there has to be transgender-related health care taught … in every med school. I think that's the only way it will really change."
The report also showed that 28 percent of those who participated were subjected to harassment in medical settings; 25 percent misused drugs or alcohol specifically to cope with the discrimination they faced due to their gender identity or expression; and 41 percent reported attempting suicide – compared with 1.6 of the general population.
"It really infuriates me that trans people are getting such poor health care," said Crandall. "It really doesn't surprise me, but it really infuriates me."
So what of the Hippocratic Oath? The doctor's pledge to do no harm?
"I think some doctors think the Hippocratic Oath applies to only treating people like themselves, and that's really frightening," Crandall commented. "But I think that's the way it's been interpreted: 'I'll serve normal people but I won't serve freaks.' And, unfortunately, that's the way a lot of doctors view all members of the LGBT community."
Crandall has her own health care horror story.
"When I just beginning to come out, I told my doctor that I was trans and his response was, 'No, you're not.' He said, 'You're not trans. It is normal for men to question their masculinity and that's what's going on with you, but you are definitely not trans,'" she recalled. "Now, that was after I had been seeing a social worker about it for five years. This doctor really did not want to treat me for anything related to transgender issues, so he kept on trying to talk me out of it."
Now, Crandall advises the transgender community to only see physicians with experience treating transgender men and women. Transgender Michigan maintains a list of trans-friendly and -experienced doctors on their website.
To read more about the Transgender Discrimination Survey: Report on Health and Health Care, or to download it, visit http://www.thetaskforce.org.