Episode 23: Part 1 - LGBTQIA+ Identity, Experiences & Challenges In Healthcare

Theme:  LGBTQIA+ Identity, Experiences & Challenges In Healthcare.

Participants: Dr Dervla McGrann (FACEM), Dr Bhushan Joshi (FACEM), Dr Ashleigh Pitcher (advanced trainee in paediatrics), Dr Kit Rowe, Dr Shreyas Iyer, and Dr Caroline Tyers. 

Discussion:
Chisolm-Straker M, Jardine L, Bennouna C, Morency-Brassard N, Coy L, Egemba MO, Shearer PL. Transgender and Gender Nonconforming in Emergency Departments: A Qualitative Report of Patient Experiences. Transgend Health. 2017 Feb 1;2(1):8-16. doi: 10.1089/trgh.2016.0026. PMID: 28861544; PMCID: PMC5367487.

Presenter: Dr Ashleigh Pitcher.

Summary:

• The purpose of this paper was to gather qualitative data about the experiences of trans and gender-diverse patients during emergency department visits within the United States.
• Data was collected using an anonymous retrospective survey between June 2012 and December 2014. 
• The primary themes that emerged were those of self-efficacy and power inequity. 
• The issues raised within this included inadequate practitioner knowledge and communication (leading to frequent misgendering of patients, discrimination and rude encounters, as well as perceived unnecessary histories and examinations). 
• The recommendations that arose from the study to improve the experience of gender-diverse patients included: 1) not discussing gender diversity with other providers unless relevant to the provision of care, 2) standardizing the practice of providers to ask all patients their preferred names and pronouns (and then using these when referring to the patient), 3) not enquiring about gender or related experiences unless related to the provision of care, 4) systemic training of emergency department providers around important aspects of trans health care (such as surgeries and their complications, hormone medications and their side effects and social stigma and marginalization of this population within healthcare settings). 

Take-Home Points:

• What it all comes down to is treating people as people, and treating people with respect. 
• It is important to remember that people may have very different life experiences from our own and that coming to an emergency department is going to be a stressful period for anyone – as healthcare providers we need to consider how we can alleviate some of this stress. 
• Ensuring that we are calling patients by their correct names and pronouns is something simple that we can all incorporate into our practice.  

 
Interlude: Dr Dervla McGrann.

Resources:

• https://www.acon.org.au/ 
• https://www.transhub.org.au/ 
• https://auspath.org.au 
• https://aifs.gov.au/sites/default/files/publication-documents/22-02_rs_lgbtiqa_glossary_of_common_terms_0.pdf 
• https://www.health.nsw.gov.au/lgbtiq-health/Publications/lgbtiq-health-strategy.pdf 

Music/Sound Effects:

• Get Away by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/deed.en_US. 
• Smile by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons / Attribution 3.0 Unported License (CC BY 3.0), https://creativecommons.org/licenses/by/3.0/de