A troubling new report has surfaced in Journal of Emergency Nursing, which detailed the humiliation experienced by a transgender man, and also sheds light on the problems a lot of transgender people face when getting health care.
The study focuses on a man given the name Brandon Jones (not his real name), who visited the ER in a trauma centre in the southeast of the US. Brandon is described in the study as a masculine transgender man, who had transitioned using hormone therapy five years prior to his visit. However, his driver’s licenses and electronic medical records identified him as female.
This is where the trouble began, as it apparently caused some confusion among the staff. Allegedly, the staff then began debating his gender out loud.
Brandon said: “”They come up and she’s like, ‘That’s a girl.’ Pointing at me saying, ‘No, that’s really a girl.’ It wasn’t business-like at all. I was a spectacle. I was a freak show at the circus. It was definitely to draw attention to the fact that my outward appearance didn’t match [my identification].”
According to Ethan Cicero, the study’s author, this experience is far too common among transgender people seeking medical help.
When speaking to CBS News, he said: “There’s really an overall lack of knowledge from everyone, providers to nurses to gatekeepers or employees responsible for checking in a patient. From a safety standpoint, I don’t know many people who would want to be in that position and stay in that environment, so often transgender people may leave.”
But, thankfully, Brandon persevered and after several hours of waiting, a nurse who had heard about what had happened spoke with him to apologise.
“She was awesome because she was matter-of-fact,” Brandon said. “She was concerned with my care. That [being transgender] didn’t matter to her. What mattered was making sure I was physically OK. That was very reassuring.”
But, sadly, many transgender people do not get such treatment. A startling number of them do not even make it as far as receiving treatment. According to National Center for Gender Equality’s 2012 report, “Injustice at Every Turn”, 19% of those surveyed had been denied care because of their transgender or gender non-conforming status. As well as this, 28% of people reported delaying medical care when injured or sick due to discrimination, and a startling 50% said they had to teach their medical care providers about transgender care.
Contained within Ethan’s report, however, are several recommendations for improving the treatment of transgender patients.
- Ask the person how he or she would like to be addressed. In James’ case, much of the public embarrassment might have been avoided if the staff members had simply asked the patient how he would like to be addressed.
- Use the proper pronoun. When speaking to a transgender patient, nurses should use the pronoun that matches the gender to which he or she identifies.
- Keep the conversation clinical. Emergency nurses should only ask questions relevant to the patient’s medical treatment during their examination.
- Be sensitive to shared spaces. When taking transgender patients into an area of the emergency department where they might share a space with another patient, keep the gender to which they identify in mind.
Brandon has shared his story in the hopes that will help prevent such incidents from happening elsewhere, and the Emergency Nursing Association has heard the message loud and clear.
Matthew F. Powers, president of the ENA, had this to say: “This patient’s story identifies new implications for emergency nursing practice when treating a transgender patient. Emergency nurses are on the front lines of treating more and more transgender patients. All patients must be treated with dignity and respect. We want nurses and their ED colleagues to understand how to give these patients the care and respect they deserve. ENA fully supports the best practices outlined in this article and supports further research around transgender emergency care.”