Are You Ready To Treat Transgender or Gender-Ambiguous Patients? An Overview On How To Begin Best Practices
Laverne Cox – actress, producer and LGBTQ advocate
At some point, you may have a transgender patient. Are you ready to ask clinically relevant questions in a professional manner? You may also treat a patient whose gender is not obvious to you or your receptionist – is your office ready to ask for pronoun preferences in a respectful way? If your answer is “not yet”, now is the time to educate yourself and staff. Transgender and gender fluid people are an important part of our communities and it is important to prepare your office on how to be welcoming and knowledgeable (see list of recommended resources below).
Unified Practice has deliberately designed its acupuncture practice management software to have personal and demographic drop-down answers to be inclusive of patients who fall outside of “male or female” gender boxes. Yes, the majority of patients will still check either male or female, but there is a growing population that will insist on defining for themselves their gender. UP is helping acupuncturists stay ahead of the curve by providing more options for self-definition for patients. This will ultimately help practitioners achieve a clearer diagnosis and treatment plan.
Some Best Practices To Consider
Below are a few best practices on how to create a more welcoming and affirming clinic to gender diverse people. I am not saying it is an easy process by any means. Broadening our fundamental notions about gender and gender identity takes time and humility. However, you can liken it to the mind-blowing learning process that you underwent to learn traditional Chinese medicine — this process inevitably deepened your wisdom and ability to understand and hold more than one truth at a time.
In fact, gender is much like the Yin and Yang spectrum. Each person has their own unique balance of Yin and Yang and this balance is complex, constantly evolving, and beautiful when seen as a whole.
Here are a few best practices to consider:
- Research and learning is a great place to start. Below are just a few resources for understanding the basics about transgender, gender fluid, gender non-conforming identities. This will help you build a vocabulary and language to be respectful and ask relevant questions to your patients.
- Talk with your family, your office, your friends about this subject and hopefully you will find allies and people who can help you learn and understand more.
- Know the difference between gender identity and sexuality. For example, just because someone presents with a more traditionally masculine “look” does not necessarily mean they are straight.
- Politely ask people’s preferred gender pronouns. For example, “Which pronoun or pronouns do you prefer?” Don’t assume that a more traditionally feminine presenting person wants to be called “she”. (Teaching your staff or student interns to do the same.)
- Inclusive language on all your forms.
- Respect confidentiality. This is a no-brainer because of patient-practitioner privacy laws, but it’s worth mentioning.
- Gender neutral bathrooms or signage that clearly affirms a person’s right to choose the bathroom that best suits them. For signage examples, visit this website: (http://www.uua.org/lgbtq/welcoming/ways/bathrooms)
- Be real. If you have a new patient who is trans or gender fluid, it’s okay to let them know you are learning and may need some guidance from them. That said, please don’t treat this patient like an object for your personal learning.
What is clinically relevant information for acupuncturists to ask about?
Here are a few things to consider, please note this is not a comprehensive list:
- Surgical history
- Top and bottom surgery, as with any surgery, will cause Blood Stasis
- Hormone treatment
- Additional sources of testosterone/yang and estrogen/yin will affect TCM and Western organs
- Menstrual Cycle
- Do they menstruate? And the usual TCM questions related to menstruation
- Chest Binding
- The practice of binding breasts for some masculine-presenting individuals inevitably causes Qi and blood stagnation
- Are they practicing safe sex and do they have multiple partners?
- Stress level
- This is a huge issue for this patient population who face much greater risk of physical attack, job discrimination, bathroom safety issues, suicide, family alienation, just to name a few.
There is absolutely no shame in deciding that your office is not ready to treat transgender and gender-ambiguous or gender-fluid patients – it takes a LOT of education, time and energy to have an inclusive office (gender neutral bathrooms help too). Please consider referring these patients out to practitioners who can offer the kind of quality care transgender and gender non-conforming patients need and deserve.
A few good resources:
- Health Care Without Shame: A Handbook For the Sexually Diverse and Their Caregivers, by Charles Moser
Guest blog post by Mamie Chow, L.Ac.