Three years ago, I found myself in a hospital waiting room upon discovering some general chest pain and difficulty breathing. To remedy my body dysphoria, I’d been wearing a chest binder that, ostensibly, had been causing problems. The hospital lacked fluency in transgender health and misdiagnosed my injury as one that would recover in three weeks. Since then, I’ve been in and out of treatments for what I now know to be a chronic pain condition. I’ve come to understand what it means for me to find queer and trans competency among health professionals.
For anyone, doctor visits may be totally anxiety-producing. For queer, trans, and gender non-conforming people, there is disproportionately decreased promise of safety or comfort. Racial and ethnic minorities therein are even more likely to be denied services and understanding. A world where gender-affirming surgeries and hormone therapies are not covered by most health insurance implies a sense of risk in marginalized identities entering a doctor’s office.
The needs of LGBTQ individuals differ greatly. I could get into my many qualms and qualifications of healthcare until the cows come home, but what good would it do to hear from one person about very isolated experiences? I took a temperature check of healthcare as experienced by local queers to explore standards of LGBTQ competency, specifically in heterosexual providers. The criteria at the root of each story make a basic rubric for respect.
It begins with the paperwork. Many patients cannot select their sex or gender when prompted with binary options of only M or F. Alternatively, medical forms could offer a wide variety of options or a blank line for limitless identification. This may symbolize a characteristic described by Pete Franzen, self-identified afraid-of-doctors person, as “being aware of and responsive to emotional sensitivity around gendered issues for people who are trans and/or gender non-conforming.”
Kelly Arbor is an HIV-positive genderqueer transsexual person and shared a story in which the intricacies of gender were met with such sensitivity. “When I was dying of AIDS I was at St. Vincent’s hospital in NYC. I was shocked to be asked by EMT personnel what pronouns I used, and then, offered a private room by the hospital because they acknowledged that room sharing in gender-specific settings can be awkward for trans folks.”
Over the years, many providers misunderstood Arbor’s gender and sexuality to such a degree that they decided Arbor was not at risk for HIV. “They made the non-consensual decision to not do a complete STI screen,” Arbor says, “even though that’s what I asked for.” The hierarchy of medical expertise paternalism over patients’ knowledge of their bodies perpetuates the ways in which misconceptions make healthcare for queer people an unsafe space.
Stephen Stratton is a female-to-male transgender person. Throughout his recent pregnancy, Stratton worked with the Back Cove Midwives for prenatal care, labor, and delivery. “They had never before worked with a pregnant transgender client. I was treated with respect, thoughtfulness.” Stratton says. “Our providers went ahead and met with and educated the nursing staff at Mercy, where we were birthing, and answered questions so that we didn’t have to.”