How avoiding an awkward waiting room conversation can contribute to better health for transgender people

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Societal biases in healthcare not only hurt a provider’s reputation but also the bottom line. When patients don’t feel welcome, they won’t come back until they are sicker and more expensive to care for. On this episode of the Voices in Healthcare Finance podcast, Rodrigo Heng-Lehtinen, executive director of the National Center for Transgender Equality, discussed what healthcare organizations can do to break down barriers to care for the transgender population.

The importance of identity documents

One of the biggest barriers is identifying documents such as a driver’s license, birth certificate and the like, according to Heng-Lehtinen. Changing one’s name and gender on these documents is time- consuming and can be expensive. There are also some states where, by law, birth certificates can’t be updated for gender. Consequently, many transgender people do not have 100% accurate and updated identity documents, he said.

“As a transgender person, you may have different names or information listed on different documents. You could very well have one name and gender on your driver’s license but a different name and gender on your health insurance card,” he said. “Every single document that you have is governed by a different set of rules.”

Healthcare providers can help clear up confusion asking a separate question on intake documents about how the patient’s name and gender appears on health insurance paperwork, Heng-Lehtinen said. He shared a personal story about the period of his life before he was able to update his identity documents.

 “I very obviously was not living as a woman, and I used the name Rodrigo at my job. All my coworkers knew me as Rodrigo. My business cards said Rodrigo. My family knew me as Rodrigo. My friends knew me as Rodrigo,” he said. “During that phase in my life, if I was sitting in a waiting room, the nurse … would call out a woman’s name because that’s what was on my paperwork, and then I’d stand up and everyone would stare. I would have to out myself as transgender in front of every single person … in the waiting room. It was a whole process just to be able to justify that I really was that person.”

Awkward conversations and outright discrimination — or even fear of those encounters — can be a powerful deterrent when transgender people consider seeking medical care, Heng-Lehtinen said.

“Patients and providers both are better served if the patient goes to the doctor at the start of an illness as opposed to when it’s totally spiraled out of control,” he said. “The more we can make everyday medical interactions easy and respectful, the simpler they become in the long run.”

Training front-end staff

Another important thing healthcare providers can do is train their front-end staff to handle gender issues and paperwork discreetly. Heng-Lehtinen described a recent encounter during which the receptionist at a physician’s office handed him an intake form asking for medical information specific to transgender people.

“He simply said, ‘The last page is for the reason you’re here today,’” Heng-Lehtinen said. “So any other patient that overheard him didn’t know what that was about, didn’t think twice about it.”

Implementing change that helps transgender patients avoid awkward conversations and have efficient access to the care they need could incentivize more transgender people to seek that care, Heng-Lehtinen said. He believes a shift toward more inclusive healthcare will contribute to better health overall for the transgender population.

“The more medical practices start adopting these tips, the more that we will see transgender health improve across the board,” he said. “As medical practices become more welcoming, transgender people are inevitably going to seek medical care earlier on, so we’ll see … outcomes improve.”

This episode was sponsored by Red Dot.