Advice for professionals to better support trans patients

About two years ago I had my first medical interaction as a trans person.

Because LGBTQIA+ circles are what I call home, I decided to ask friends what I could expect when seeking medical care. To my surprise, this survey sent me on a long and eye-opening journey into the state of healthcare for trans people in America.

Here’s what I learned about how doctors are failing trans patients, and tips on how we can do better.

For many people, the first step to getting a general medical exam would be to find a medical professional. However, it’s not that simple for many trans people – myself included.

One in five transgender people report being discriminated against in medical settings because of their identity.

It’s sad at best and scary at worst that trans people still have to use side channels and whispering networks to find out which medical professionals are safe to see. But alas, when it was time for me to have a medical examination, that’s exactly what I had to do: I asked my friends for recommendations.

Transgender people are at higher risk of unemployment due to workplace discrimination. Because of this, we are often uninsured or uninsured with the same protections as our cis counterparts. Luckily, I take out market insurance, but for many trans people I know, that’s not the case.

While scheduling my medical exam, I got a short list of medical professionals who took my insurance. However, I quickly discovered other significant challenges during and after the dates.

About half of trans people say they need to tell their healthcare professionals about being trans, and my experience was no different.

Even though the doctor I finally saw was at least aware that trans people exist, the front desk staff abused me and shouted my dead name in front of the entire waiting room audience. All of this despite having clearly provided my correct name and pronouns on the paperwork prior to my appointment.

While I can handle these errors at the moment, not everyone can. In some cases, this can cause trans people to cut off medical care altogether.

Many trans people also report experiencing harassment or even physical violence on dates, in addition to medical and insurance incompetence.

Health professionals can and should do a lot to make their environment more trans-positive. Let’s review some tactics that make all the difference for trans people seeking care.

Most people’s first interaction with a doctor’s office will be through their website or over the phone.

When I browsed my now primary care professional’s website, they had degendered language (“vaginal health” instead of “women’s health,” for example), inclusive intake forms, and an LGBTQIA+ section. All of these things suggested that I would be in good hands.

To create a welcoming and inclusive environment for all patients, especially trans people, intake forms should include a field for:

Sex assigned at birth and sexual orientation are generally not required to appear on a medical admission form. However, some people may want their healthcare professionals to have this information, or it may be in some way specifically related to the reason for your visit.

Regardless of what a person’s insurance information says, a person knows – better than any clinician – how they want to be addressed. The form field additions listed above show potential patients that their clinician is giving them control over their own medical experience.

Moreover, these measures help not only trans people, but all other people who have a name that is not their legal name. It’s a win-win!

Due to their redundancy, the expressions “gender pronouns” and “preferred pronouns” are considered obsolete and no longer used. You can just ask for “pronouns”.

Another imperative to creating a trans-affirming medical space is to ensure that staff who answer the phone are properly trained in phone etiquette. It’s important to ask for a caller’s name and pronouns and be prepared to explain to people what the pronouns are if a caller doesn’t know.

Medical circles are educational in nature, so people go to the doctor to learn more about their bodies and their health. Why shouldn’t this setting also be able to educate on pronouns if needed?

Staff answering phones in a doctor’s office should also prioritize asking for someone’s chosen name over their legal name. Also, they should not make assumptions based on a person’s voice.

Many times I have been asked if I was “going on a date for my wife”. I was even asked several security questions because someone does not believe that I am who I am. It has to stop!

More importantly, everyone in your workplace, from administrators to clinicians, mustLGBTQIA+ health skills training.

This may involve attending a professional panel or conference, using free online resources, or hiring an expert to train your staff.

Your local LGBT center can probably help you access educational materials and refer you to a consultant for training. The center can even offer in-house training services.

See the end of this article for free online resources from national organizations and nonprofits.

Taken together, these simple actions – adjusting online forms and materials, training your staff in basic phone etiquette and LGBTQIA+ skills – create an affirming environment for all patients.

People should never have to worry about bias and unequal treatment when they go to the doctor (or anywhere). Having a visible and accessible anti-discrimination policy is essential, ideally next to the entrance or reception.

It is important not only to be respectful and inclusive of patients on the phone and during admission, but also throughout their experience in your practice.

Here is a list of things healthcare professionals should NOT ask or say to trans patients during an appointment:

  • What is your real name?
  • Did you have the “operation”?
  • Be patient with me. I will probably mess up your name and pronouns.
  • There’s a lot I don’t understand about transgender people and their issues. Can you teach me?

Healthcare professionals should never expect trans patients to be responsible for educating them about trans bodies, health, or identity. They should avoid asking unnecessary questions that have nothing to do with the patient’s visit – often asked entirely out of personal curiosity, not professional duty.

Countless times, one or more of these things have happened to trans people I love, and they’re not the only ones. It’s important that trans people feel less like an “experiment” or side attraction and more like a human being in need of a routine checkup. Keeping unnecessary sights to a minimum preserves the dignity of the person sitting across from you.

Much of the discussion around trans health focuses on gender affirming care (GAC). But trans people are people – we have to go to the doctor for a sudden illness, a chronic illness or an annual physical exam like everyone else!

Trans literacy in the medical community is essential. When doctors take the Hippocratic oath to do no harm, this includes intentional or unintentional harm to trans people.

What a healthcare professional may think is just a small error in their attitude or treatment of a patient could have a negative impact on a trans person’s quality of life and well-being.

Trans people have higher mortality risks related to health complications. In this particularly hostile time towards LGBTQIA+ people in the United States, the medical community has an obligation to take care of us. And you can start by implementing the tips identified in this article.

Everyone deserves access to safe and competent health care. There are so many other hurdles in life that trans people navigate above medical care, including an increased risk of unemployment and homelessness and a greater likelihood of being the target of physical violence.

The less a medical professional can and should make the experience of seeking medical care as painless as possible.

This article provides tips for respecting trans patients before and during their appointments, which may or may not relate to GAC.

With respect to GAC, the predominant diagnostic criteria for dysphoria or gender incongruence come from the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5)” and the International Classification of Diseases (ICD-11).

However, some doctors and patients find the inclusion of these diagnoses stigmatizing, creating a system of control around the GAC that harms trans people and others.

It may be helpful to know that there is a free alternative resource for understanding GAC and trans health needs from the World Professional Association for Transgender Health (PATH). This is called the Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People.

Books and guides for healthcare professionals working with trans patients also include:

Below are other trusted resources for trans, non-binary, and gender-nonconforming people that may be helpful to those seeking care and those providing it:

KB Brookins is a poet, essayist and cultural worker from Texas. They are the author of How to identify with an injury (Kallisto Gaia Press, 2022); liberty house (Deep Vellum Publishing, 2023); and Pretty (Alfred A. Knopf, 2024).

Follow them online at @earthtokb.


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