Under Attack: How Current Events Affect the Health and Well-Being of Our Transgender, Non-Binary, and Gender Fluid Patients


This week has brought new and distressing news about the potential for a change in the way that transgender Americans are identified. Though details are still being released, this could include even up to an invalidation of the existence of transgender individuals based on the erroneous perception that gender is defined only by the sex that was assigned to a person at the time of birth. This could have a huge impact on transgender, non-binary, and gender fluid Americans. Transgender folks alone in the United States number approximately 1.6 million as of 2016.

Additionally this week, the United States Department of Justice dealt a blow in telling the Supreme Court that discrimination based on gender identity did not violate federal law.

This one-two discriminatory punch has our transgender clients and patients reeling, as they struggle to not feel like the latest pawn in a political struggle as we inch closer to the midterm elections.

Trans patients are being seen in every type of clinical practice, and even the threat of these policy changes can leave folks feeling “othered” or even erased. As clinicians, we must do that much more to increase our intention to ensure that trans patients feel seen, heard, and respected in all practice areas.

What can we do, both urgently and in the long term, to reach out to and assist those who we serve in our practice, to ensure their health and safety?

The first step is to educate ourselves on the issues and concerns of the transgender and non-binary population. There may be mental health needs that flare up at this particularly stressful time when people are on edge, and transgender folks may be at particular risk of violence or self-harm at this time as well.

In addition, we must keep up to date on policies that govern transgender individuals in the state in which we provide care. We can take the time to learn about how to best document names and pronouns in patient records to affirm their identities.

You might consider reaching out personally to affected patients who you know well, letting them know that they have your support as their health care provider and that you are aware of the stress that they might be under at this time.

As health care providers and therefore scientists, we must recognize that the complicated nature of sex and gender is much more than a cultural construct. It is based in biology too! We know scientifically that there is no single marker that places humans into only two sex brackets of male and female, and that it is much more nuanced. We must resist the conversation that implies differently. We must support our trans patients where they are, either in a binary of man/woman, or living outside of it, without imposing our own biases upon them.

This would also be a great time to take a look at your documentation and staff education, to be sure that you are presenting a welcoming and affirming health care home. Patients and their families feel validated and respected when they see that their provider has taken steps to create a safe space in which they can be fully open about their identity and concerns. Small steps can go a long way in ensuring an environment that celebrates each patient and family for exactly who they are.