TRANS-INCOMPETENT HEALTHCARE – A FATAL EPIDEMIC

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“Hi, could I speak with Brittany please?”

This phone call is not how I wanted to wake up today.

Excuse me??”

“This is Janet*, from your doctor’s office. Is this Brittany?” the nurse asked.

“My name has been legally changed for a year and a half. It has been updated on all my prescriptions, in my medical file, and on all my legal documents. When I became a patient at this LGBT-serving clinic, I was explicitly told that staff would make an effort to recognize people by their preferred names rather than their legal one. I tolerated these mistakes back then, but now I have jumped through all the hoops of legally changing my name. It’s more than a year later, and you are still not calling me Brandyn.

“Aren’t you the same person who left a voicemail for me three months ago when you made this same mistake then, too? Haven’t I already sent you two very politely-worded emails asking you personally to please check whatever medical records you’re looking at to see that they’re updated correctly?”

I might not sound so harsh if I weren’t certain that the answer was yes, that I had explicitly told this nurse twice before to stop calling me by the name I was assigned at birth… Or if I’d even had the chance to get out of bed first, before the burden of navigating a trans-incompetent medical system came bearing its weight down upon me once again.

“Oh. Uh, yeah, you know, this is the name that was in the email I’m looking at. I’m not sure who made that mistake. So, you’re, uh – your name is, uh,“ the nurse stammered without apology.

“My name is Brandyn. What can I do for you, Janet?”

“I’m just checking to see if you’re back from you winter trip. You’re due for a checkup with your doctor so he can continue to prescribe your Truvada for PrEP.”

“I’ve already made the appointment. It’s scheduled for next Wednesday. Is there anything else?”

What the nurse doesn’t seem to understand about her duty as a healthcare professional is this: She is a tiny, important piece of a very complex, oppressive system in which refusing to provide adequate care to transgender people is associated with a 60 percent rate of attempted suicide – 1.5 times higher than the already deplorable 41 percent rate when calculated independently of how our doctors treat us, and 13 times higher than the US national average of 4.6 percent. There is unambiguous, positive correlation between how carelessly medical professionals treat us and whether or not we give up on being alive.

When Janet called me, it wasn’t just one small mistake she made. That one mistake exponentially compounded my reality of being told every day that my identity is not legitimate, that I don’t really need to be represented in population samples for medical research, and that I just have to smile and nod when cisgender people are disrespectful toward me. Her phone call came on the heels of a brief leave of absence I’d taken from work because I felt sufficiently overwhelmed by the transphobia present in everyday conversation. So much so, that I could not safely interact with the outside world at all for a time. If I want to go a whole day without being subjected to some degree of transphobic comments, I pretty much have to go a whole day without talking to other human beings.

But I didn’t really feel like I had a choice to interact with this nurse, despite my discomfort about answering the phone for anyone at all. She called me, in my own home, as I lay in my own bed, where I had been trying for three consecutive days already to move past the persistent pain and exhaustion of being transgender in this society. I thought my health depended on answering that phone call. Instead, her trans-incompetent ignorance, without a hint of apology, sneaked into my vulnerable space cloaked inside the Trojan Horse of My Best Medical Interests.

Is it any wonder 54 percent of trans folks refuse to get checkups or preventive medical care in order to avoid the disrespect and discrimination we face from our healthcare providers?

We need this to stop. We need medical professionals to be more interested in lowering the transgender suicide rate than in soothing their wounded, defensive egos when their mistakes are pointed out to them. We need the people we entrust with our health to understand that if we can’t get them stop hurting us, we’re likely to stop the pain by removing ourselves from the equation altogether, exercising control over our suffering in the only way we see how.

Our lives depend on this – and it’s my understanding that healthcare professionals are supposed to be in the business of saving lives. First, do no harm.

I’d like to see us all celebrate National LGBT Health Awareness Week by stepping up to cultivate awareness about the existence and the struggles of transgender people. Can we take the extra few seconds to look at a patient’s file and make sure we have the right name? And take personal responsibility for our mistakes when we miss the mark? Can we acknowledge that every patient or client we encounter is living in some degree of pain we know nothing about, and that it is the responsibility of medical professionals not to add to that pain?

I think we can. You have the power to save countless lives. Let’s celebrate awareness of transgender health together by each of us doing our part to be the change we want to see in the world.