"I’m trans, and I’ve avoided going to any doctor for a long time. I have no idea how to find someone who will understand and make me feel safe. How do I find a trans inclusive doctor?? And what should I ask once I’m there to make sure they’re actually accepting?"
-Question submitted by Anonymous
Riley Johnson Says:
Congrats on seeking care after some time away! I have had this tendency for avoidance a time or two myself. Accessing care and being consistently on top of one’s health can be a challenge for trans folks. In 2011, the National Transgender Discrimination Survey found that 28% of respondents postponed medical care due to discrimination and 48% postponed because they couldn’t afford it. So we are definitely not alone, unfortunately. There is definitely help on the horizon though.
RAD Remedy is a community-driven, nonprofit organization that created the first review and referral site for trans, gender non-conforming, intersex, and queer health. The Referral Aggregator Database (RAD) is live in open beta and has approximately 3,000 providers with more being added daily. RAD Remedy aims to make it possible for folks to find great doctors nationwide and know precisely what to expect when accessing care. Providers come to RAD in one of three ways – through an intensive questionnaire about their practice and expertise, through referrals from community organizations, and through the reviews of folks like us who have seen the provider. I would encourage you to check the database first, and if you have trouble finding what you need, drop RAD Remedy a line and we’ll work with you to find a good solution. [I can be reached at firstname.lastname@example.org.]
Next, I’d like to talk briefly about strategies for getting care safely and knowing the questions you can ask to find a welcoming and knowledgeable provider. I think it’s important to be real and say that we as trans folks need to meet providers where they’re at. Looking for a provider who is an expert and has many trans clients is great, but it can be unrealistic at times depending on your location. More often you will find a provider who is interested in serving trans clients but hasn’t done so yet. TransLine operates a medical consultation service to help those providers, and RAD Remedy works with providers to improve their practices, forms, and processes to make them more welcoming.
It’s also important to note that what I consider acceptable in a provider may not be what you might. Gather all of the information you can and make the best choice for your situation. Before you make your choice, I find it’s helpful to sit down with yourself and identify the following:
Must Haves: [an example from my list: providers must use my right name.]
It Would Be Nice: [an example from my list: I would prefer that a provider has experience with trans clients but I’m willing to work with one who hasn’t done so yet.]
Dealbreakers: [an example from my list: messing up my medications, being hostile or fatphobic, etc.]
Some key questions you can ask the provider (or ask the front desk person to ask the provider personally) to ascertain whether or not a provider is trans-affirming:
1. I am a transgender man (trans woman, nonbinary person, etc.) in need of primary care/gynecological care/etc. Will this be a problem?
2. Does the provider have experience with trans clients?
3. Have the provider and clinic staff been trained about trans issues?
Here are some best practices for providers serving trans clients (and ways patients like us can subtly see whether a provider is affirming):
*Do the intake forms have a spot for preferred name and/or pronoun?
*Does the office location have gender neutral or single stall restrooms?
*Does the office art reflect the clientele? If there are pictures, are the people in them diverse in age, race, etc?
*Does the office have magazine subscriptions for LGBTQ publications?
*Does the office have an efficient and transparent means of providing feedback or complaints if needed?
Here are some key general strategies for getting the most out of your time with your provider and feeling safe while you do it:
*Use the buddy system. Other than in some domestic violence screenings, you’re allowed to have a friend or loved one in with you for office visits and exams. You can insist that they come in with you to the exam room.
*Know the questions you’d like answered or the medical issues you’re having. Some folks find it helpful to jot down a short list so they’ve got a plan for the visit. Try to keep your list short and prioritized, since you often won’t have a lot of time with the provider.
* If you are concerned about information being listed “on the record”, discuss the issue with your provider. Providers will usually tell you the sort of information they feel compelled to record and what can be discussed “off the record”.
*Take notes when in with the provider (or have your buddy do it). It can be hard to remember what gets said in a visit – particularly if you’re nervous.
Lastly, know that you have the right to access health care without experiencing discrimination. Earlier this year, a federal court in Minnesota issued a preliminary ruling that discrimination against an individual because of his gender identity is prohibited under Section 1557 of the Affordable Care Act. For more information on how to file a complaint with the Department of Health and Human Services (usually after a provider-based complaint has failed or if things are particularly egregious), check out their website.