Majority of transgender patients report negative experiences in emergency departments

A new study out of Western University (London, Canada) has found the majority of transgender patients have had a negative experience when it comes to receiving emergency department (ED) care. The findings, by first author Greta Bauer, PhD, is in press at the Annals of Emergency Medicine, the official publication of the American College of Emergency Physicians, and is now posted online.

The study used respondent-driven sampling, a methodology developed to specifically address the challenge of studying hard-to-reach populations. It relies on a snowball sampling, using current study subjects to recruit future subjects. In total, 408 transgender people in Ontario, Canada were included in the analysis; 214 female-to-male, and 195 male-to-female. Findings include:

• 21 per cent of transgender people report having avoided the ED in a potential medical emergency because of fear of negative experiences.
• Among those who did attend the ED, 52 per cent had experienced at least one of the trans-specific negative experiences asked about in the survey (e.g. having a doctor refuse care, or refuse to examine parts of your body) while presenting in their felt/core gender.
• 32 per cent experienced hurtful or insulting language
• 31 per cent were told the healthcare provider didn't know enough to provide care

"As far as we're aware, this paper represents the first published paper to examine the experiences of transgender patients in emergency department settings, and is based on data from our longstanding project, Trans PULSE," says Bauer, an associate professor in the Department of Epidemiology and Biostatistics at Western's Schulich School of Medicine & Dentistry.

Interest in this issue has been high. The journal will be publishing an accompanying editorial that makes strong arguments for changes to ED practices. It calls for better training of medical students and residents, the provision of safe environments within the ED (for example: gender-neutral washrooms) and monitoring of the provision of care. ACEP Now, the news publication of the American College of Emergency Physicians will also be including a feature article on issues raised in this paper in its March issue.