Trans Lifeline Library:

Allies and Supporters

Care Provider Allies

Allies and Supporters

Allies & Supporters

Care Provider Allies

If you work in a field or facility that provides physical or mental healthcare to the public, you will encounter transgender patients. It’s important that you take this into consideration when designing intake forms (do you have a place to put a chosen name, personal pronouns, and gender identity?), staff policies (has everyone from the receptionist to the care providers and administrators received DEI training from a transgender-competent source? Does your staff know to check the chart to confirm what name and pronouns someone uses before entering the room? If dealing with health concerns involving genitalia/chests, are you asking what terms a person may be comfortable with using when discussing their body?), and selecting more LGBTQ/ Transgender/ socially conscious educational options for your continuing education credits.

While many trans individuals are willing to answer health-relevant questions and some basic questions about being transgender, it is your responsibility to take the time to also round out your knowledge base as it relates to transgender care. Your patient is there because they’re seeking care services or education from you, not the other way around. Even if you are not performing surgeries or prescribing hormones, it’s crucial that you do not place the full burden of educating a care provider on the patient seeking care.

A common complaint among transgender folks is that many times, our providers will blame real ailments on our gender-affirming hormone therapy, or treat us as if all of our health concerns are only related to being transgender. This is harmful, in much the same way that dismissing patients with higher BMIs by carelessly assuming that all of their health concerns are related to having more body fat is harmful. If a transgender patient presents with the flu, it’s not because they’re trans or taking hormones, it’s because they’re a human being existing during flu season. Unless a trans person is presenting with an issue that is directly correlated to their gender-affirming treatment, it’s usually safe to assume that the two things are not related.

Be aware that the ways you code for billing may affect your patient. Some insurances, for example, will cover general therapy, but not therapy that’s specifically coded as being for gender dysphoria. If your patient receives a sex-specific procedure that does not align with the gender marker on their insurance (in applicable states), be prepared to help explain to insurance that it was an appropriate and necessary procedure, and that it does need to be covered. Transgender people are statistically more likely to face hardships like poverty, unemployment, and housing instability–doing what you can to help make care accessible and affordable is incredibly meaningful.

Many, but not all, transgender people come to appointments prepared and well-researched–we often expect to encounter providers who are not well-informed or educated on our specific healthcare needs, and have had to embrace a culture of self-advocacy as a matter of survival. If your patient speaks to you from a well-informed, confident place of self-advocacy, please don’t be offended or feel put-off if they ask more challenging questions, disagree with something you’ve said/done, or are asking about specific diagnoses/treatments. While you may be the medical expert in the room, trans people are the experts on their needs and experiences–being able to collaborate with your patient and set aside egos is an allyship skill. Many of us have had to fight to be heard and respected in therapeutic and medical settings, or had our trust damaged by providers who were uninformed or dismissive of our concerns. Taking the time to hear out your patient, demonstrating your own commitment to becoming informed on your own time, and validating their concerns about how they may be or have been treated is so important to changing the narrative of trans healthcare. When people feel safe and respected attaining care, they’re more likely to actually show up to preventative care appointments and address health concerns while they’re still minor and manageable.

Take the time to find or create your own templates for things like therapist letters, gender marker change letters, and letters that support requests for gender affirming hormone therapy/surgical procedures. There are dozens of sample letters that have been proven/tested to meet the required criteria that are available online, and having your own version ready-to-go is a huge green flag for trans patients–it’s nice when we don’t have to be the ones to provide templates/repeatedly remind our providers to write one. It’s a small way of showing that you’re aware of our needs and that you’re willing and prepared to meet them!

If you’re looking for information on providing healthcare to trans patients, curious if any medications may react negatively with different hormones, etc., resources like UCSF and Fenway Health have excellent treatment guides and up-to-date information.

Resources:

Adolescent Health Working Group–LGBTQ Youth & Provider Communication Handouts

American Psychological Association–Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (PDF)

American Physical Therapy Association–Five Ways To Be an LGBTQ Patient Ally

Callen Lorde–Protocols for the Provision of Hormone Therapy

SAMHSA–A Guide For Understanding, Supporting, and Affirming LGBTQI2S Children, Youth, and Families

University of California, San Francisco–Guidelines for the Primary and Gender-affirming Care of Transgender and Gender Nonbinary People

Fenway Health–Medical Care of Trans and Gender Diverse Adults

Fenway Health–Medical Care of Gender Diverse Children and Adolescents

Fenway Health–Gender Affirming Surgery Letter Template

Fenway Institute–LGBTQIA+ Health Education Center

Gender Confirmation Center–How To Write A Letter of Support for Surgery