Hello all of you beautiful tungsten atoms! After meeting so many of you this weekend, I know that you all bask in the diversity of your patient base. You look around at your treatment room and grin at the variety of economic, racial, age, professional, and etc., etc. profiles of your patients. It sure takes a full spectrum to make a bright light! I’m writing here to bring you another slice of the rainbow. You can do these five easy things to make your clinic even more GLBT friendly:
1. Post a non-discrimination statement on your website and hang it in your office.
2. Make your health history forms friendly.
3. Remove gender from your bathrooms.
4. Get to know your local GLBT community.
5. Learn some more.
Following is more detail on how and why to do each of these. This material was developed for the CANference 2011, and was delivered in a breakout session on Sunday. All of the following is also in the handouts:
1. What: Post a non-discrimination statement on your website and hang it in your office.
How: Here’s a sample from the AMA:
“This office appreciates the diversity of human beings and does not discriminate based on race, age, religion, ability, marital status, sexual orientation, sex, or gender identity.” Get bonus points for adding “height, weight, national origin, language, education, HIV status” to the list.
You can also hang a “Safe Zone” poster in your window. You don’t need a fancy one – you can find an example online and hand-make one – just include a pink triangle and the words “Safe Zone.”
Why: The GLBT community, and Trans people in particular, often experience medical facilities and medical personnel as hostile, disrespectful and/or derisive. As a means of self-protection, many of these people will “screen” your clinic to see if there’s any clue that you might be open and responsive to their needs. This screening may be a visit to your website, and e-mail, a phone call, a walk-by, or any number of creative ways to find out who you are and what you stand for.
2. What: Make your health history forms friendly.
How: Use one all-inclusive form rather than separate M/F forms. Don’t label the sections “male” and “female” when asking about prostate, menses, etc. Group the questions for your convenience, and label them as “fill out if applicable”
Leave a blank for “relationship status”.
Don’t ask “gender,” which is not about biology, ask “sex” and leave a blank for people to fill in rather than simply M/F options.
If you are talking to a patient and are not sure what pronoun to use, just ask.
Why: Transgender people may need to enter medically relevant information in both the “male” and “female” sections of their health history. One unified form lets these folks know that they are welcome and expected. Also – a friendly form is more likely to elicit more honest answers. For example, a trans-man who has to choose between gendered forms will likely choose the male paperwork, leaving no opportunity for the two of you to discuss menstrual issues. Likewise, a trans woman will most comfortably choose the women’s intake, leaving you no natural opportunity to talk about prostate health. Trans people may identify as simply M or F, or as MtF, FtM, genderqueer, or any number of variants.
3. What: Remove gender from your bathrooms.
How: If you have more than one, and they are single-stall, label each of them as all-gender bathrooms. If your facility has multi-stall bathrooms, be sure there is at least one single-stall bathroom and that it is labeled as all-gender. This will also be helpful for parents attending differently-gendered children, and caregivers attending differently-gendered persons with disabilities.
Why: “Some people often feel uncomfortable when using segregated restrooms. Female/male sex-segregated bathrooms are not accessible spaces that everyone can use. Many people are subject to harassment, intimidation, legal charges, and violence on an every day basis.
Transgender, genderqueer, and/or gender non-conforming people are particularly affected by bathroom segregation because of the visible gender differences that may not correlate with cultural gender norms. Even in cities, towns, and college campuses that are generally considered “liberal” places where it is “easier” to be gender non-conforming, many people are still harassed in both women’s and men’s rooms.”
4. What: Get to know your local GLBT community
How: Find your local GLBT Community Center:
Connect with your local PFLAG Chapter: Parents, Families, and Friends of Lesbians and Gays:
Consider setting up a booth at your annual gay pride event, or using some of your marketing dollars to sponsor events through the GLBT center.
Why: Many GLBT centers maintain a resource referral list, whether formal or informal. It is common practice for GLBT folks to use these lists to find friendly practitioners for services from healthcare to babysitting to tax prep help.
5. What: Learn some more
How: If You Want to Learn More about Transgender Issues, and You Have:
Read: “Top 10 Things Transgender Persons Should Discuss with their Healthcare Provider” A publication of the Gay and Lesbian Medical Association, attached and at https://www.glma.org/_data/n_0001/resources/live/Top%20Ten%20Trans.pdf
Watch this YouTube Video on Transgender Basics. It is informative without being at all dry or didactic. It is very well produced and clear, and I found the people interviewed to be witty and admirable: https://www.gaycenter.org/transgenderbasics
Watch this 2001 documentary: Southern Comfort, available by mail from Netflix. It is about Robert Eads, a Transgender man who was denied medical care by over 20 doctors, and eventually succumbed to ovarian cancer. This is a nice personal profile documentary – it doesn’t drag the viewer through the tortuous medical path Robert had to tread, but rather paints a compelling and warm portrait of Robert and about half a dozen of his friends and family as they live out their lives as gender-variant people in the American deep South.
If You Want to Learn More, and You Like to Read Fiction:
Middlesex, by Jeffrey Eugenides – 2007
Stone Butch Blues, by Leslie Feinberg – 1993
If You Want to Learn More, and You Like to Read Non-Fiction:
Gender Outlaw: On Men, Women, and the Rest of Us, by Kate Bornstein – 1995
Gender Outlaws: The Next Generation, by Kate Bornstein and S. Bear Bergman – 2010
Why: Most GLBT folks would love to walk into a clinic knowing that they don’t need to educate you about the basics of their identity, their relationships, or, for Trans people, the unique health issues related to their hormone levels or surgeries. Don’t expect them to educate you, though some may be willing. It is a classic marker of privilege to demand that those who are not similarly privileged educate us about their struggles.
But, I don’t see many of these people… Where are they? Trans folks often avoid health care offices whenever possible. They avoid going to the dentist, they forego regular health checkups and screenings, and even if they do come in, they may not reveal their trans status if at all possible – because it has not been safe or comfortable.
Based on our best guess at total population percentage, here’s how many trans folks you can/will see if you are successful in breaking down the barriers to healthcare:
Pxs per week Pxs per year Trans Folks/year One every
30 1,500 10 5 weeks
50 2,500 16 3 weeks
80 4,000 26 2 weeks
100 5,000 33 1.5 weeks
200 10,000 65 Week or less
400 20,000 130 2-3 days
Point #1: GLBT folks are still subject to serious discrimination. Trans folks in particular have been subject to extreme prejudice. Besides daily discrimination in employment, housing, credit, civil rights, and access to basic public accommodations, they suffer a murder rate that is 17 times the national average.
Point #2: We will have the opportunity to help these people.
Point #3: We will lose that opportunity if we are not prepared. They will screen us, and only come in if we “pass” the screening.
Point #4: We have an ethical responsibility, and therefore an amazing opportunity, to reach out and compensate for a social injustice.
Shine on, people!