Providing a Safe Space for Transgender Patients
Several weeks ago, a provider called my office to ask questions regarding office visit interactions with transgender patients. I was very pleased this provider, who has been in practice for several years, sought to consult with an Inclusion & Diversity practitioner to heighten their cultural awareness on engaging transgender patients (through a history and physical exam) with the intent of not being unconsciously discriminatory or offensive.
During our conversation, the provider discovered that their response to patients’ medical care (such as transition surgeries, hormone and steroid therapies) and other medical care pertinent to the patient’s transgender status would be discussed no differently than any other patient medical history. I reminded the provider to be mindful and respectful of using the patient’s preferred name and pronouns and as a best practice, also to document a preferred name in the patient’s electronic medical record to assist in creating an affirming and respectful encounter for our transgender patients. By the time we ended our phone call, the physician was much more comfortable and confident. I asked the physician to please follow up with me after the patient encounter to further discuss opportunities and celebrate successes.
I received the follow up phone call by the physician who was happy to report the patient encounter went extremely well. The patient was so impressed by the physician’s approach that the provider gained the patient’s trust. The patient then felt safe and comfortable enough to share their personal journey and medical history on gender transitioning. The provider reported, “It took our relationship to another level.” Both the patient and the provider learned so much from each other that day.
Establishing trust is critical in cross-cultural relationships. The truth is that becoming culturally competent is a journey, not a destination. We never arrive regardless of position, title, or role we play. We must be willing to be humbled and open to explore possible biases that can hinder outcomes and relationships – no easy task. In this case, the patient’s medical compliance was at stake. This is a great example of cultural humility at its best displayed by the provider’s willingness to be respectful of another individual’s truth. This encounter was an excellent example of a success story that may not have been so successful had the provider not sought Inclusion & Diversity consultation and resources.
We will experience wins and we will all have opportunities to do better next time. However, if we can walk away with a greater sense of awareness, respond with sensitivity and empathy that produces positive action and outcomes, better known as cultural competency, this is always a win for an equitable tomorrow.
Margarita Diaz, MSN, RN
Manager, Health Equity Initiatives
Office of Inclusion & Diversity
The MetroHealth System