As coronavirus sweeps across the country, many transgender people are likely to be faced with an excruciating choice: go to a hospital where they might face discrimination or tough it out at home.
One in three transgender people faced discrimination at a health care provider in just a year, according to the 2015 U.S. Transgender Survey, and 23% avoided seeing a doctor because they feared they would be mistreated.
The advent of the coronavirus may leave many transgender, nonbinary, and intersex folks without a choice when it comes to seeking out health care in the coming months. Trans health experts say there are several things that gender-diverse people can do to ease the stress of entering unfamiliar health care systems during the crisis.
Dr. Nick Gorton, a trans ER doctor and a primary care physician at Lyon-Martin Health Services in San Francisco, says that even he has reservations about going to the ER as a trans person.
“It’s always going to be scary when you encounter a health care provider that you don’t know is okay with [you being trans],” he tells NewNowNext. “I’ve gone in for unscheduled care or seen a new primary care provider and have been like, I hope they’re okay with this.”
Gorton often advises trans people to consider bringing an ally with them to the ER or doctor. In a pandemic, when everyone is forced into quarantine, however, that isn’t possible.
Dallas Ducar, clinical lead for mental health services at the Massachusetts General Hospital Transgender Health Program, recommends trans people make sure that, if they do have to go to the hospital, they bring a phone charger.
“Or bring some way to really be able to connect with people if you're not going to be able to have anyone with you,” Ducar tells NewNowNext.
Gorton adds that those allies can still be present when you have to talk to doctors or nurses by calling in.
“Have them on the phone,” says Gorton. “Let the doctor or nurse know, ‘Hey this is my friend, Joe, they’re an advocate for me. I just want them on the phone so they can hear things. They know about my medicine.’”
Pandemic aside, a hospital can already be an alienating experience for trans people.
“Going to the ER is a much more isolating experience [during the pandemic], at least early on in this and if we don’t end up doing something like Italy, where it’s literally wall-to-wall patients,” says Gorton. “Bring something with you that’s going to help stave off worry—for most people, that's their cellphones.”
Ducar and Gorton also advise that trans people compile as much medical documentation as possible in the event that they need to go to the doctor or hospital. That means a detailed list of prescriptions, medical history, physician contact information, and any records of surgeries. Having this information on-hand will ease stress and speed up check-ins, alleviating the strain on the medical system.
Dr. Helen Webberley, a trans health expert and founder of GenderGP in the United Kingdom, says that the sooner trans people can tell intake staff they are trans the better.
“‘I happen to be trans, but I don’t want that to interfere with my health care,’” she advises patients to say. ‘I am worried that I have coronavirus.’”
Webberley also suggests saying something along the lines of: “I am entitled to fair health care and you must not treat me differently than any other patient.” She points out that most hospitals have diversity and patient liaisons for people who experience discrimination.
"One thing that I find has really helped a lot of times is a pronoun pin,” says Ducar. “Or even, sometimes, a kind of written statement to be able to just help people—and to not exhaust [yourself] by trying to say something over and over and over again.”
The bottom line, experts agree, is that trans people can do a bit of planning to alleviate a lot of anxiety and pain later should they need to go to the ER.
“I think preparation is the key,” says Webberley. “It’s no different whether it’s corona or [a different illness].”