You Have A Pain In Your Chest And Arms… What Do You Do?

For most people they would call 911 to be taken to an emergency room but for trans people that might be what they fear most.

What It's Like Being Transgender in the Emergency Room
One patient described the experience as making them feel like “the freak show.” But some hospitals are forging a path toward inclusive care.
National Geographic
By Susmita Baral
March 19, 2018

Visiting a hospital emergency room for medical attention can make anyone feel vulnerable. But for transgender patients, the experience can be even more harrowing. Gaps in staff knowledge about transgender health contribute to patients’ uncertainty about receiving prejudice-free, competent care. That in turn leads to alarming statistics about the well-being of the transgender community.

Today, roughly 0.6 to 0.7 percent of the American population identifies as transgender, and these people have disproportionately high rates of illness and death—in part due to widespread reluctance to seek out emergency treatment and even routine checkups over concerns about the quality of care. (Here's how science is helping us understand gender.)

In a study in the February edition of the Annals of Emergency Medicine, transgender adults who visited the ER overwhelmingly reported that health care providers lacked competency in issues specific to the transgender community. For instance, many providers did not understand the meaning of “transgender,” and they lacked experience with and knowledge in trans-specific treatment, such as the effects of hormone therapy or complications from reassignment surgery.

One subject in particular said prior hospital experiences left them feeling “like the freak show.” Similar encounters led to many participants saying they had avoided seeking out emergency care for fear of mistreatment, discrimination, and harassment.

One trans person I know who was hospitalized recounts a story of their hospital stay; she was in a ward with three other patients, one morning her doctor was leading a group of med students and her doctor was talking about her in the third person and about her being trans all in hearing of the other patients. She said she felt like a specimen on exhibit.

“When you’re that vulnerable, that’s the worst time to have to worry about people reacting to you,” one participant said. Often, the burden falls on patients themselves to educate their health care providers, according to a survey conducted by the National LGBTQ Task Force. But as transgender awareness grows, so does interest in formally educating medical professionals.

Another person tells the story about when she slipped and fell on icy, she could hear the emergency room personnel saying that they didn’t want to deal with “it.”

At New York University Langone Medical Center, transgender actors are trained to serve as so-called standardized patients, people who act out common health scenarios, to better prepare future professionals for patients with non-binary gender identities. Richard Greene, the director of gender and health education at the medical center, says it’s instrumental to have transgender individuals act as patients to keep the training authentic.

I understand that this is being done at a number of Connecticut medical schools.