Everyone deserves to feel safe, comfortable, and respected in healthcare settings, but that's not always the case for transgender patients. Transgender men might already feel out of place in clinics that predominantly serve cisgender women or when receiving procedures that are typically performed on women. Thus, it's important for care providers to create inclusive healthcare environments, policies, and procedures that put these patients at ease.
What are the best practices for making transgender men feel seen and respected during pelvic ultrasound appointments?
Provide Staff Training
Staff awareness, education, and sensitivity is critical to delivering inclusive healthcare and building trust with transgender patients. Yet, nearly half (47%) of trans adults say the medical professionals with whom they've interacted know little to nothing about providing healthcare for trans people, according to a 2022 KFF/Washington Post survey. Thirty-seven percent report difficulty finding providers who treat them with dignity and respect, and 30% say they've had to educate a healthcare provider about transgender people, had a provider refuse to recognize their preferred gender identity, or been asked invasive questions about their gender identity that were medically irrelevant.
The burden to educate healthcare professionals should be on the provider, not the patient. It's important for everyone in a healthcare practice—from medical professionals to front desk staff and anyone else who interacts with patients—to receive sensitivity training that includes appropriate ways to ask about names and pronouns, as well pejorative terms to avoid (e.g., "tranny" or "transvestite").
The American Journal of Roentgenology recommends that all clinical radiology staff be educated on "appropriate terms, communication techniques, gender-affirming surgical procedures, hormone treatment options, the prevalence of mental health disorders, health care disparities, and screening guidelines as they pertain to LGBT populations."
Create Gender-Inclusive Policies and Paperwork
Providing inclusive healthcare experiences means not singling out transgender individuals but rather giving all patients the opportunity to communicate how they want to be addressed. Asking all patients about their preferred name and pronouns normalizes the interaction for staff and welcomes transgender patients to disclose their identities.
Just because a patient is a transgender man doesn't mean they prefer masculine pronouns. Nearly half (48%) of trans adults prefer they/them pronouns, 37% use he/him, and 8% use something else entirely.
The American College of Obstetricians and Gynecologists (ACOG) recommends that all patient forms include check boxes for all gender and sexual orientation options and/or include blanks for patients to write their responses. It also recommends creating office policies where patients' preferred names, gender markers, and pronouns are clearly marked on all patient records, clearly communicated to all staff, and used consistently by everyone who interacts with patients. Finally, ACOG emphasizes the importance of teaching staff how to apologize for mistakes if they happen.
Foster an Inclusive Healthcare Environment
Ensuring a private and safe space for the ultrasound is essential, especially considering that transgender patients may experience heightened anxiety or dysphoria during such procedures. Facilities should have policies in place to protect patient confidentiality and dignity.
ACOG also recommends the use of gender-inclusive signage, a clearly posted sign with the office's non-discrimination policy, and the availability of at least one gender-neutral bathroom.
Communicate Clearly and Sensitively
From the moment of scheduling to conducting the ultrasound, clear and empathetic communication is vital. This includes discussing the procedure in detail, understanding the patient's medical history, asking about any concerns they might have, and taking the time to address those concerns with sensitivity and professionalism.
Clinicians need to understand the effects of hormone replacement therapy on the pelvic region and tailor the ultrasound technique accordingly for accurate results. Just as importantly, they need to understand how the patient feels about the procedure so they can make the experience as comfortable as possible. This could mean limiting the number of people in the room and/or allowing them to bring a loved one for support. If a patient is experiencing extreme anxiety about the procedure, clinicians might consider suggesting relaxation techniques, offering to play music the patient finds relaxing, or even offering medication or the option for sedation during the ultrasound.
Personalize the Patient Experience
Transgender people are just like everyone else, meaning they're not like anyone else. Everyone has different preferences, sensitivities, and needs. Providing inclusive healthcare for transgender patients means fostering an environment that makes all patients feel seen and respected, asking the right questions to understand each individuals' concerns and needs, and building trust with effective communication.
