Transgender people face discrimination in health care

Many transgender men face discrimination in U.S. health care settings, according to a new study.

About 42 percent of female-to-male transgender adults reported verbal harassment, physical assault or denial of equal treatment in a doctor's office or hospital, the researchers report.

"Over a third of participants in the study were blatantly mistreated when they tried to get healthcare," said Deirdre Shires of Wayne State University in Detroit.

She and co-author Kim Jaffee write in the journal Health and Social Work that past research found transgender people often face discrimination or harassment in various areas of life, including health care.

The little research that does exists tends to focus on male-to-female transgender people, they write. For this study, they focused instead on female-to-male people.

Their data came from a 2008-2009 survey of 1,711 female-to-male transgender people from the U.S. and its territories. Most were ages 25 to 44.

Over three quarters lived full-time as their nonbirth gender. A similar proportion reported some type of medical gender transition.

Asked about experiences in doctors' offices or hospitals, 28 percent said they'd been denied equal treatment, about 32 percent reported verbal harassment, and about 1 percent reported physical assaults.

Shires emphasized that it's not clear who discriminated against the participants. Additionally, she said, the results may not apply to the entire transgender community.

One researcher not involved with the study told Reuters Health by email that she wasn't surprised by the findings.

If anything, the study may underestimate the problem, "because the sample was skewed towards young, white, college-educated people with jobs and private health insurance," said Dr. Laura Erickson-Schroth, a psychiatrist at New York University in New York City.

"If 42 percent of that group is reporting discrimination, the number may be even higher for others," said Erickson-Schroth, who is the editor of the book Trans Bodies, Trans Selves.

A next step, Shires said, would be to find ways to improve health care experiences for transgender people.

For example, she said, it's still difficult for many transgender people to identify themselves on medical forms as anything other than male or female.

"At every point in the health care system if you’re transgender there is no place for you," she said. "There is no way to identify yourself and it’s a vicious cycle."

Erickson-Schroth pointed out that 65 survey participants said they never accessed care at a doctor's office or hospital.

"Though this is a small number, I can't help but wonder if they avoided care completely because they feared harassment or discrimination," she said.

While the medical community is beginning to make changes to improve care for transgender people, Erickson-Schroth said progress is slow.

"The most important step the medical community needs to take toward ending discrimination against transgender people in clinical settings is educating providers," she said.

Previous research found that medical schools only spend an average of five hours on lesbian, gay, bisexual and transgender issues. Some schools never discuss the topic at all.

The education of health care providers should start in school, said Erickson-Schroth, but shouldn't end there.

"It should happen in hospitals and clinics as well," she said.

The World Professional Association for Transgender Health (WPATH) and GLMA: Health Professionals Advancing LGBT Equality have searchable databases of providers with an interest or expertise in working with transgender people, Erickson-Schroth said.

Also, she pointed out, people can often report discrimination to clinics and hospitals, or they can contact organizations such as the National Center for Transgender Equality or the Transgender Law Center.