A new study published in the Annals of Family Medicine discusses transgender patients’ experiences with clinicians in the United States and Canada. Thirty transgender adults were interviewed. Their responses reflected themes of how medical professionals are frequently insensitive toward patients — asking questions deemed invasive, irrelevant, or stigmatizing, "misgendering" them (including calling patients "he" or "she" if they identify as "non-binary" or "agender"), and providing poor care.

In this political climate, new studies about gender have been enlightening. In this case, I learned some new vocabulary, including "Xicanx" (which is a woker version of "Chicano"), "apogender" (which means that someone doesn’t feel the concept of gender applies to them), and "ontological oppression" (which refers to the stigma experienced because a person doesn’t fit into pre-defined categories of gender).

I, of course, wasn’t in the room when any of the reported clinician-patient exchanges occurred, so it’s possible that the healthcare professionals in question were indeed insensitive, inappropriate, or demeaning. At the same time, some health-related questions that may initially come across as intrusive or irrelevant, such as those related to biological sex or hormones and surgery during a medical visit that isn’t centered on transition-related care, may have a purpose that patients aren’t aware of. Potential ones include medication interactions, implications for dosage, or future complications.

Additional concerns cited by participants in the paper include that gynecology and obstetrics are binary and carry the assumption that patients are women. Furthermore, one "non-binary" person (who, perplexingly, also identified as a woman) questioned why someone taking exogenous estrogen would need to tell clinicians this, considering that natal women have estrogen in their bodies. Another participant identified as someone who "does not believe in gender," which begs the question as to how a person can self-identify as both transgender and neither gender.

The study supported a cultural shift in medicine, including a revision of curriculum, paperwork, and policies to be more inclusive and less "violent." Considering that so many clinicians are already terrified of doing or saying something that could lead to being labeled hateful or "transphobic," the last thing we should want is to inject more fear and intimidation into working, in any capacity, with patients experiencing gender dysphoria. This will only lead to a further attrition of objective practitioners treating this population and activist-minded ones taking their place.