Transgender patients often face healthcare disparities such as stigmatization and discrimination when receiving healthcare. published in the American Journal of Roentgenology addressed what imaging leaders and radiologists can do to prevent this from happening and provide compassionate care.
“Too often, patients do not receive care that is as understanding and compassionate as it could be, in part because health professionals are not well educated about sexual issues in patient care,” wrote authors John S. Sowinski and Richard B. Gunderman, MD, PhD, with the department of radiology at the Indiana University School of Medicine. “Fortunately, the last couple of decades have seen a surge in research into the needs of lesbian, gay, bisexual and transgender (LGBT) patients and practices that can help to meet these needs. Unfortunately, such information often fails to reach radiology department personnel, and the care of LGBT patients likely suffers as a result.”
The authors provided numerous examples of how imaging leaders and their staff can provide transgender patients with the compassionate care they deserve. These are three suggestions taken from their analysis:
1. Provide a welcoming clinical environment.
It is the responsibility of radiologists, technologists and all other radiology personnel to “pursue cultural competency and provide informed and educated care to their patients,” Sowinski and Gunderman wrote. And providing such care begins as soon as the patient walks through the door.
“One of the first opportunities to provide culturally competent care to transgender patients is in the waiting room or triage area, where patients often look for signs of inclusivity,” the authors wrote. “Examples include printed materials such as posters, brochures, and magazines that indicate a commitment to serving the LGBT community. Competency training that addresses transgender health for clinical personnel, including the front desk staff, nurses, and technologists, enables radiology personnel to feel more prepared to interact with transgender patients.”
2. Practice cultural humility.
Recognizing and respecting your patients’ cultural identity helps “discourage stigmatization and avoid preconceptions about gender identity and sexual orientation,” the authors wrote. Asking patients for their preferred names and pronouns is another small step that can go a long way.
Sowinski and Gunderman noted that offering gender-neutral bathrooms and using the appropriate gender terms are other ways providers can create “a safe, welcoming environment for transgender patients.”
3. Keep up with recommendations unique to transgender patients.
To provide truly compassionate care to transgender patients, radiologists should pay close attention to published guidelines that will help them provide high-quality care.
“Many transgender patients choose to undergo hormonal or surgical interventions for gender reassignment, also referred to as gender-affirming procedures,” the authors wrote. “These interventions have been found to improve the quality of life of patients with gender dysphoria, enabling them to live more congruently with their preferred gender. However, the clinical implications of these interventions have the potential to go unnoticed until they present as pathologic conditions.”
For instance, the authors explained, transgender men keeping their vagina, cervix, uterus and ovaries “retain the risk of pregnancy, reproductive malignancies and related conditions.” And transgender women with a prostate and testicles “maintain their risk of related pathologic conditions and acquire increased risk of breast cancer if undergoing hormonal therapy.”
Sowinski and Gunderman went on to provide an in-depth list of published guidelines related to transgender patients imaging leaders should make sure their employees understand. This includes, for instance, breast cancer screening guidelines for transgender women who are using hormone therapy and transgender men who have undergone a bilateral mastectomy.
Awareness of LGBT issues has increased, the authors wrote, but there is still significant work to be done, and radiology personnel can educate themselves and their colleagues to make a difference and provide additional value to transgender patients. “Continued research will help to establish even stronger evidence-based guidelines for transgender care,” they concluded.