Healthcare

How many times have we had to training our healthcare providers about trans healthcare? At one doctor’s appointment before I transitioned I was reading off a list of my meds and when I got to estradiol he asked what I was taking that for and I told him that I’m trans. He closed his laptop and said I was his first trans patient do you mind if we talk about it. It was great that he wanted to learn, but it was really not the time or place to learn, but I did do a short Trans 101 for him.

Online there is a research paper published by Mary Ann Liebert, Inc. publishers about the amount of transgender training that student doctors get.

Transgender Health
Implementation and Evaluation of a Pilot Training to Improve Transgender Competency Among Medical Staff in an Urban Clinic
Published in Volume: 1 Issue 1: January 13, 2016

Introduction
Despite increasing awareness of their extreme marginalization, transgender individuals (TGI), who identify their gender as different from their sex assigned at birth, continue to face widespread discrimination, maltreatment, and ostracism, including in social and healthcare services. Providers often lack expertise in adequate transgender (TG) care due to limited specialized training. A survey of 150 US and Canadian medical schools found that the median total time dedicated to LGBT-related content was 5 h, with zero instruction hours during clinical years. The least represented areas of the curriculum regarding TGI were aspects related to medical and surgical transition care.

In addition, many social service and medical providers hold transphobic beliefs that result in denial of services, and verbal and physical abuse directed toward TG patients. Consequently, TGI evidence low rates of healthcare utilization (HCU) and increased morbidity and mortality than other groups, especially evident among TGI of color.

Hostile service-provision environments and lack of cultural competence have been linked to TGI suboptimal care and elevated risk behaviors. In a national survey (N=6450) examining experiences of TGIs including in the healthcare domain, 19% were refused medical care due to their TG identity, 50% had to teach their providers about TG issues, and nearly a third (28%) postponed seeking care due to anticipated discrimination or financial difficulties (48%). TGIs of color experience most discrimination.
[…]
Examples of health system level barriers include the challenges associated with ordering tests that appear to be discordant with a person's affirmed gender, for example, obtaining a cervical pap smear for a TG male or prostate-related tests for a TG female. Other problems can arise with billing systems that reject codes on the basis of perceived “incorrect” gender, or insurance companies that may reject claims based on apparent gender discordance. Other barriers to care include refusal of commercial insurance to routinely cover gender-affirming services, and the designation of TG persons as having “gender identity disorder,” which is regarded by many community members and healthcare workers as pathologizing. The barriers most cited about clinical experience with TG patients are related to inadequate knowledge about the general and transition-related health needs of TG clients.

I am just waiting for annual checkup to see have my new insurance company handles me having a mammogram and PSA test done at the same time.