Respecting the Privacy of your Transgender Patients

I’m sure many of you have had patients who are transgender. One of the first things you look at before treating a patient is their medical history which often times will include evidence that the individual has transitioned. *gasp*

What now!?

How ever must you proceed??

Quite frankly, in many cases, you proceed pretty well as you would with any other patient. 

Is this part of their medical history relevant to what they are being treated for? Then perhaps it will be necessary to ask more about any operations they had and more specifics on the hormones or other medications they are taking. And I don’t believe you should feel afraid to ask them questions when it’s relevant.

But I do think you need to consider that last part…is it relevant to your treatment?

If it is relevant, then be mindful to ask the patient these questions in private. This is a very personal part of who they are and not all people who are transgender necessarily want to talk about it in the open clinic with other people around. They went through quite the ordeal getting to where they are today (much of which includes stress you have no clue about). So be respectful of this part of their medical history and ask them in private about details. Maybe you’ll find them to be quite open about it, but that isn’t your call to make, it’s theirs. Also remember transgender people suffer from gender dysphoria to varying degrees and some may not want any reminding or referencing of their former lives. This is doubly important with early transition transgenders where misgendering and deadnaming can be hurtful. Please make sure legal names are covered or out of the way to prevent these issues.

Another point I really wanted to make in this video is this: avoid gossip with coworkers regarding patients who are transgender. I’ve found myself twice already where a patient who is transgender is in our clinic and someone who saw that private piece of their medical history just couldn’t keep it a secret. These patients were well transitioned…it was NOT obvious that they were transgender. And now, suddenly, I saw this very intimate and private piece of who they were being shared without permission (and quite frankly in violation of HIPPA) and it really bothered me. I know it seems innocent and I think it’s important that I even mention that everyone I work with is cool with transgender folk (I don’t want to insinuate that they talked badly about these individuals and I’m so thankful that is not the case). However, privacy is privacy. It’s not your place to share any medical history with someone else in the clinic just for the sake of gossip. 

One of these patients was my patient and I had really good rapport with them…but even I never talked to them about it because it was not relevant to the specific injury they had and they gave enough written information on the medical history form that I didn’t feel the need to ask more. This person was a man. Simple as that. I saw them as a man and it was quite obvious that is who they identified as. Why bring up their history of transition to them or a coworker if it wasn’t relevant to treating them? If they volunteeringly brought up their story, that is a different situation where more conversation could be had. But there really are a lot of transgender folk who don’t want to be asked about it unnecessarily. They just want to be as they are and we owe it to them as their healthcare providers to maintain that privacy for them.

I am not transgender, but I really care about patient privacy, particularly so of a patient population that is already very vulnerable in society. Let’s try to care more for our patients who are transgender, respect who they are, and maintain the privacy of their medical history.