A Culture-Centered Approach to Improving Healthy Trans-Patient–Practitioner Communication: Recommendations for Practitioners Communicating withTrans Individuals

Abstract

The following manuscript explores trans individuals' lived experiences with practitioners and the types of advice they suggested be provided to practitioners treating trans patients to improve the trans-patient-practitioner relationship. Thirteen semi-structured qualitative interviews were conducted with individuals who self-identified as trans. Interviews were analyzed using thematic analysis (Braun & Clarke, 2006; Owen, 1984). Data analysis revealed that changes in practitioner's communication behavior during office visits as well as modifications to office logistics and e-health particulars would contribute to a healthy communication environment. Interviewees explained that these variations may potentially improve trans-patient-practitioner communication. We conclude by offering practical and theoretical implications as well as areas of future research for trans health communication.

Transgender peoples’ experiences and perspectives about general healthcare: A systematic review

“…Healthcare provider communication. This theme was also present in 18 of the 20 reviewed studies (Bauer et al, 2009;Bauer et al, 2015;Costa et al, 2018;Dewey, 2008;Guss et al, 2017;Hinrichs et al, 2018;Hudson, 2018;Kosenko, Rintamaki, Raney, & Maness, 2013;Lindroth, 2016;Pitts et al, 2009;Poteat et al, 2013;Riggs et al, 2014;Ross & Bell, 2017;Shires & Jaffee, 2015;Taylor, 2013;Vermeir et al, 2018;von Vogelsang et al, 2016;Westerbotn et al, 2017). The main sub-themes within HCP communication were related to the perceived acceptance or denial of the trans patient's identity and/or the professionalism displayed.…”

“…All other studies were considered satisfactory. Most qualitative studies were appraised as satisfactory or good, with 5 of the 12 studies considered good overall (Hudson, 2018;Linander, Alm, Hammarström, & Harryson, 2017;Poteat, German, & Kerrigan, 2013;Roller, Sedlak, & Draucker, 2015;Ross & Bell, 2017). Studies rated as poor or satisfactory failed to discuss researchers' reflexivity to a satisfactory standard; however, this was the only criteria where studies rated as satisfactory did not meet the criteria for good quality (Bauer et al, 2009;Lindroth, 2016;Taylor, 2013;Vermeir, Jackson, & Marshall, 2018;von Vogelsang, Milton, Ericsson, & Strömberg, 2016;Westerbotn et al, 2017).…”

“…Experiences where the patient's trans identity was perceived to be denied by the HCP were the most negative, however overvaluation or undervaluation of the trans aspect of the patient's identity were also recounted as negative by participants (Bauer et al, 2009;Dewey, TRANS HEALTHCARE EXPERIENCES AND PERSPECTIVES 12 2008;Hudson, 2018;Lindroth, 2016;Ross & Bell, 2017;Vermeir et al, 2018;Westerbotn et al, 2017). Denial of identity was felt by the use of insensitive language and terms when referring to trans people, and the use of incorrect pronouns or the patient's birth name (Bauer et al, 2015;Guss et al, 2017;Kosenko et al, 2013;Pitts et al, 2009;Ross & Bell, 2017;Taylor, 2013;von Vogelsang et al, 2016). Participants also perceived HCP discomfort, uncertainty and awkwardness as denial of the trans identity (Bauer et al, 2009;Dewey, 2008;Guss et al, 2017;Hudson, 2018;Kosenko et al, 2013;Pitts et al, 2009;Poteat et al, 2013).…”

“…Overvaluation of the trans aspect of identity was perceived by experiences of HCPs attributing any health issue to the patient's trans identity, even if the reason for seeking healthcare was not trans-related (Bauer et al, 2009;Ross & Bell, 2017;Westerbotn et al, 2017). Undervaluation was perceived in encounters where the HCP completely ignored the trans aspect of the patient (Bauer et al, 2009;Dewey, 2008;Vermeir et al, 2018).…”

“…Negative experiences were largely related to perceived or actual disrespect and mistreatment (Bauer et al, 2009;Costa et al, 2018;Hinrichs et al, 2018;Hudson, 2018;Kosenko et al, 2013;Lindroth, 2016;Pitts et al, 2009;Riggs et al, 2014;Ross & Bell, 2017;Taylor, 2013;Vermeir et al, 2018;Westerbotn et al, 2017). 2009was told to "find god not hormones" (p. 488); a participant in Ross & Bell (2017) shared a similar experience. Participants perceived rough physical examination technique, insufficient disclosure of medical information (e.g.…”