Challenges in the Office
This study shows that gender minorities are an at-risk group, and healthcare staff should be encouraging and provide a welcoming environment for them. “We hear over and over from gender minority individuals that they have problems when entering the healthcare system,” Dr Boehmer noted. Many of their issues concern the medical office staff. When patients enter a doctor’s office, the first person they see is the receptionist. That person’s training should have included how to appropriately address a gender-minority patient.
One patient, two names The patient’s legal documents may not match their gender presentation. For example, the patient prefers to be called “Jane” but her legal documents state her name as “John.” This can create a challenging situation. The office should have procedures in place to record the patient’s preference so the gender-minority patient does not have to correct someone or feel discomfort when addressed in front of others. The office might not be able to accommodate the discordance stemming from the patient having one name on their legal documents but identifying by another name. No one should have to sit in a waiting room looking like a woman and have to respond when someone calls out “John.”
The pink issue Another concern is the décor in clinical locations. For example, mammography centers are usually decorated in pink. “We don’t have to have pink gowns; they can be purple or any color,” explained Dr Boehmer. The gendered environment creates an obstacle. A patient might be sitting in a gynecologist’s waiting room surrounded by women, pink décor, and snapshots of babies. If that is a transgender man who has a beard and a deep voice, he is in a situation that creates discomfort.
Encourage Their Personal Support Team
“What I always think about when I think about cancer survivorship is that we always hope individuals with cancer don’t have to go through this experience alone — that they have someone with them at critical moments,” Dr Boehmer said. So for transgender patients or gender minorities, we usually also want them to bring someone with them for support or as a second set of ears to hear our explanation of all the options.
Our message to oncology staff is to please be welcoming to those caregivers or support providers as well, explained Dr Boehmer. They might look different, but again there are easy things to do, such as avoid using very heterosexist language. There is no need to make everything gendered. Just ask if there is someone whom the patient would like to bring along when you discuss these treatments. Having a more open way of communicating, then being more welcoming to whoever that person is are essential when treating a transgender patient.
Boehmer U, Gereige J, Winter M, Ozonoff A, Scout N. Transgender individuals’ cancer survivorship: results of a cross-sectional study [published online March 5, 2020]. Cancer. doi:10.1002/cncr.32784