Health Care is Challenging, Especially to Transgender Patients
As a cancer center that values and respects people from all backgrounds, Moffitt Cancer Center adopted policies more than a decade ago that ensure transgender patients receive the same quality of care as any other patient who come through the doors. Cathy Grant, vice president and chief diversity, equity and inclusion officer, answers a few questions about the unique issues transgender patients face and discusses ways in which Moffitt is ensuring its facilities and treatments are comfortable and accepting of all.
Why are health disparities found in the LGBTQ+ community, particularly among people who are transgender?
I think the transgender community has historically faced a lot of discrimination in the health care setting and in other settings throughout the community. Lack of trust is a major barrier to care — the fear that they won’t be treated well upon arrival or they just won’t have a good experience is a foremost worry.
Past unfavorable health care experiences may result in concerns that the care team may be biased or lack knowledge about their health-related concerns. As a cancer center, we are working to ensure transgender patients are comfortable and can focus on their screening and treatment in an environment that is sensitive to their needs. Proactively overcoming mistrust is absolutely necessary to close health equity gaps.
How does Moffitt identify a transgender patient?
Collecting sexual orientation and gender identity data in electronic health records is essential to providing high-quality, patient-centered care. The National Academy of Medicine and the Joint Commission recommend sexual orientation and gender identity data collection as a way to learn about which populations are being served and to measure the quality of care provided to LGBTQ+ people.
When it comes to identifying a transgender patient, research suggests that having an opportunity to self-disclose gender identity information sensitively is ideal. That means a patient should be presented with the questions about gender identity or sexual orientation as early as possible in the continuum of care. This ensures transgender patients are treated in culturally competent ways (e.g., referring to the patient by their preferred name and pronouns) and areas of clinical relevancy are addressed (e.g., hormone treatment adherence, fertility issues and appropriate screenings) from the onset.
How does an organization like Moffitt prepare for treating transgender patients?
The LGBTQ+ community faces significant health disparities, including disproportionate rates of tobacco, alcohol and drug usage, and increased rates of depression and anxiety. The clustering of these risk factors is hypothesized to result in increased cancer burden in both incidence and stage of diagnosis. There is still much research needed and availability of better data will allow health care providers to better serve the individual needs of LGBTQ+ patients. Moffitt’s researchers are leading some of this important work.
On the care side, a hospital workforce that is prepared to meet the needs of transgender patients is foundational. Hospitals nationwide are working to make sure they are better prepared to meet the needs of the LGBTQ+ community in general. At Moffitt, the strategies range from data collection to educating team members to community outreach. While the education includes the importance of inclusion, it also covers the basics, such as the difference between sex, gender and sexuality. We want the average person to understand these concepts at a minimum. We work to demystify that gender is a spectrum and help our team members understand the nuances of caring for a transgender person versus a gay man, a lesbian or someone who is bisexual, for example.
Why should communication be approached differently when treating a transgender patient?
Moffitt is 10th on the DiversityInc Top Hospitals & Health Systems list in 2023.
A transgender person’s internal sense of self is different from cultural expectations based on the sex they were assigned at birth. Communication is critical as it values the person’s internal authentic sense of self, regardless of their visible presentation. Recognition through the use of preferred name and appropriate pronouns of who someone feels themselves to be internally is the beginning of an affirming interaction. This is where trust begins.
How does Moffitt handle transphobia from nonstaff members, like patients or other guests?We want everyone who walks into the cancer center to have the best possible experience. All patients must be made comfortable and welcomed during their cancer journey. We support our team members by providing guidance on how to respond during uncomfortable situations and ensure that we are equitable with our policies and procedures.
We also visibly support and celebrate different cultural backgrounds to send a message of inclusivity to everyone, including patients, visitors and team members. Regardless of who walks through the door, we want them to know we support inclusion for everyone.
