August 2019

Any time we need healthcare, we are put in a vulnerable position. We need a healthcare professional to understand our symptoms in the context of our individual lives. Human nature is such that most people find it easier to relate to those with whom we share similar traits and values, whether they are related to gender, age, income-level, ethnicity, religion, political affiliation or even hobbies. So, it stands to reason that we look for doctors and other providers who we feel understand something about who we are as whole people. Without support from a healthcare professional, we cannot get medication, surgery, or any number of other potentially life-saving treatments. Thus, when our healthcare providers accept us for who we are, they create a safe space where hopefully we feel comfortable, free of judgement and ready to engage in wellness.

But what if we couldn’t find any medical providers available in our community who could relate to us? According to a 2017 Gallup poll, approximately 5 percent of people in the United States (5 out of 100) are members of the LGBTQ community, which means they are far less likely to find a medical provider with the same sexual preferences or gender identity. Those with gender dysphoria (transgender people) number closer to 5 out of every 1,000.

Transgender Discrimination

Although awareness and acceptance are improving, transgender people continue to face widespread discrimination in healthcare, housing, employment and self-expression. An extensive nationwide study published in 2011 reported that 90 percent of the 6,450 transgender and gender non-conforming study participants experienced harassment or discrimination on the job and 20 percent experienced homelessness. With regard to obtaining healthcare services, 28 percent of transgender study participants postponed medical care due to discrimination and 48 percent postponed care because they could not afford it. Additionally, a staggering 41 percent of study participants had attempted suicide, often in their adolescence or early adulthood. Adolescents are more likely to engage in self-harm when they do not feel safe and accepted at home. If you are the parent or family member of a transgender or gender non-conforming child, the most important thing you can do is to let them know you love them and you support them.

I am encouraged by younger generations who have less prejudice and fear around sexual preference and gender identity. Studies show that children and adolescents who identify as a certain gender almost always continue to identify with that gender, regardless of the gender they were assigned at birth. The University of California San Francisco is doing important work with transgender youth, everything from hormone therapy to gender reassignment surgery. For parents and other loved ones, UCSF is a great resource for information. If you have questions, check out their website at www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center.

Courtesy and Respect

When it comes down to it, we all want courtesy, respect and a sense of belonging. It is amazing how small considerations on the part of cisgender people (those having a gender identity that is commonly considered to match a person’s assigned sex) can have a hugely beneficial impact. For example, by simply making an effort to address people with their preferred pronoun, “he” or “she,” we demonstrate value for who they are. Fear and stigma can often make this effort feel difficult, but it doesn’t have to be. If you’re not sure how to address someone, it is okay to ask, “What’s your preferred pronoun?”. Caring is demonstrated in wanting to get it right.

I went to graduate school at Samuel Merritt University in Oakland to become a family nurse practitioner, a job that I love. During my time there, through mentorship and friendships, I was fortunate to be both academically and socially educated on comprehensive care for transgender and LGBTQ patients. These lessons continue to resonate through my practice today. At MCHC Health Centers, we continually update our approach to ensure all people feel safe and welcome, this includes members of the transgender and LGBTQ community. It is with pleasure that we are here to deliver comprehensive and respectful care anytime it is needed.

Erika Gary is a family nurse practitioner at Little Lake Health Center, part of MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental and behavioral healthcare to people in Lake and Mendocino Counties.