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Transgender Patient Services and Support Resources

Serving Transgender Patients

Does your organization have a policy or policies that specifically outline procedures and practices aimed at eliminating bias and insensitivity, and ensuring appropriate, welcoming interactions with transgender patients?

To receive credit, a facility must have:
An official written official policy (or policies) that cover at least three of the topics following topics. This is a different policy than your patient non-discrimination policy.

  • Recording of preferred name and pronouns in paper and/or electronic admitting/registration records
  • Use of preferred name and pronouns when interacting with and referring to transgender patients
  • Protocols for interacting with transgender patients
  • Guidelines for room assignments for transgender patients
  • Access to restrooms
  • Compliance with privacy laws
  • Access to items that assist gender presentation
  • Access to continued hormone therapy
  • Addressing potential problems with insurance/billing claims

Resources:

The creation of policies and procedures aimed at eliminating bias and insensitivity, and ensuring appropriate, welcoming interactions with transgender patients and training staff on these policies is particularly important in light of Section 1557 of the Affordable Care Act. Section 1557 prohibits sex discrimination in any hospital or health program that receives federal funds, and courts and the U.S. Department of Health & Human Services, Office of Civil Rights (OCR), has made it clear that this prohibition extends to claims of discrimination based on gender identity and sex stereotyping.

For more information about best practices for care of transgender patients and sample policies, see the publication Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies, from HRC Foundation, Lambda Legal, and the LGBT Rights Committee of the New York City Bar Association.

Examples:

Does your organization offer transgender specific services?
To receive credit in the HEI, a facility must:
Offer one or more of the following types of service:
  • Comprehensive, multidisciplinary clinical care program for transgender adults
  • Comprehensive, multidisciplinary clinical care program for transgender and gender-expansive youth
  • Trans-affirming gynecological care, including cervical cancer screening and pelvic exams
  • Hormone therapy and monitoring
  • Psychological, physical, and psychiatric evaluations
  • Gender confirming surgeries
  • Referrals for gender-confirming surgeries
  • Preoperative and postoperative care for gender-confirming surgeries

Here are some examples of facilities that offer transgender-specific services:

Does your organization have an externally promoted multidisciplinary gender clinic for either adults and/or youth?

Transgender, non-binary, and gender-expansive communities face unique challenges in healthcare settings and in obtaining health services. Within LGBTQ healthcare, it is necessary to recognize these barriers and work towards combating them. 

Each year, we see an increasing amount of healthcare facilities taking steps towards trans-inclusive care by creating comprehensive programs for transgender, non-binary, and gender-expansive communities. This interactive map details where clinical care programs can be found specifically for gender-expansive children and adolescents. 

To receive credit, a facility must:
Have a concentrated clinic focused on providing comprehensive and inclusive health services explicitly for transgender people.

Examples:

  • Children’s Hospital of Pittsburgh of UPMC has an entire Gender and Sexual Development Program focused on providing inclusive and competent care for gender expansive youth. 
  • The University of Virginia has two transgender clinics, one for teens and young adults and another for adults. UVA shows that they are committed to providing trans-affirming care to patients of all ages. 
  • VA Greater Los Angeles Healthcare System created their own Transgender Services Clinic as a way to improve healthcare services for trans veterans. 
  • The Transgender Health Clinic at Cincinnati Children’s serves transgender youth in an intentionally affirming atmostphere and provided support for both these children and their families.
Does your organization have a specific program or position to provide patient navigation/advocacy services to transgender patients?

To receive credit, a facility must:
Have a volunteer peer navigation program or a dedicated employee(s) position, whose primary role is to serve as an advocate/navigator for transgender patients.

Examples:

  • Northwell Health informs patients about their transgender patient navigator through this brochure.
  • Penn Medicine’s Transgender Patient Advocate Program “assists patients in finding appropriate providers, making appointments and ensuring optimal care for transgender patients at their facilities.”
  • UCSF has a Transgender Care Navigation Program that works with partner providers and clinics to assist transgender, gender nonconforming, and non-binary people seeking general healthcare or gender-affirming medical care at UCSF.  Check out the job description for their transgender patient navigator position.
Does your facility offer all gender restrooms in public areas for patients and visitors and/or have clear posted signage indicating a policy that allows individuals to use the restroom that aligns with their gender identity?

As The Joint Commission’s LGBT Field Guide notes: “Patients whose appearance might not conform to gender stereotypes may feel more comfortable and safe in a single-stall or unisex restroom. Design or clearly identify at least one such restroom. These single-stall or family restrooms can also serve parents caring for opposite-sex children, disabled people accompanied by opposite-sex caregivers, and any other patients wishing to use them. Although making a unisex restroom available is an important signal of acceptance, patients should be permitted to use restrooms that comport with their gender identity and should not be required to use the unisex restroom.”

Note: While single stall bathrooms are important to offer, we also strongly recommend a policy that ensures that patients and visitors may use the bathroom that corresponds to their gender identity.

Examples:

  • The All Gender restroom at Callen-Lorde Community Health Center promotes inclusivity for all patients.
  • NYC Health and Hospitals affirms their patients' gender identities with this inclusive bathroom policy sign.