A clinician stepping out and calling a name into a lobby full of waiting patients may seem like no big deal, but for a transgender youth patient waiting for an appointment, it can cut like a knife.
“When a clinician walks into a room, the birth name on your chart is the first thing they call out,” explained Tai Jordan, a 17-year-old transgender youth. Tai, whose birth name is ‘Tairah,’ was born female, but identifies as male. “If you’re not out yet, or you pass as the gender you identify with and use a different name, the clinician has inadvertently outed you in a public space where you should feel safe.”
Seattle Children’s researchers Dr. Yolanda Evans want to better understand the issues that transgender patients and their families face in healthcare. They have launched a survey for parents of transgender youth patients with the goal of better understanding healthcare experiences and barriers. Families who are interested in participating in this research study can send an email by clicking here or call 206-884-1433 to learn more. The survey takes about 15 minutes to complete and each participant receives a $10 gift card.and
“We want to hear how transgender youth and their parents navigate the healthcare system, what barriers they might encounter and how they gain information about transgender health,” said Breland. “By analyzing the data, we hope to make positive changes for these young people when they go see the doctor.”
In Tai’s medical chart, his gender is listed as ‘female.’ But Tai identifies as a male, uses male pronouns and takes testosterone. He has been living as male for years and has felt for a long time that physically and mentally, he is a guy.
Breland, a pediatrician who specializes in adolescent issues and studies transgender medicine at Seattle Children’s Research Institute, met Tai after he came to Seattle Children’s in 2013 for an emergency surgery to remove bilateral teratomas, which are cystic growths. Tai’s reproductive health was discussed due to the placement of the teratomas, and he was then referred to Breland.
“Dr. Breland and I talked about what a transition would look like,” Tai said. “I’ve been on testosterone almost a year and I feel much better. I see changes in my body and voice and it’s empowering. When I went through puberty originally, I felt nothing toward the changes in my body.”
Carmen Jordan, Tai’s mom, observed the evolution in her child as he developed his gender identity.
“At first he came out saying he was gay,” Jordan said. “As he came to have more information, he said, ‘No—I’m not gay. I’m transgender.’ I was happy for him, but also scared. I was afraid of what people would say and if they would accept him.”
Along with concern about Tai’s safety came love from family.
“Tai worried about opening up to extended family, but everyone was accepting,” said Jordan. “It’s about the love you have for the person, and in our family the love is unconditional. It was about Tai and it didn’t matter if he was a boy or a girl. We cried, we hugged, and we’re just happy for him.”
Avenues to improve healthcare for transgender youth
Breland and Evans have received some preliminary feedback in their survey that studies barriers for transgender youth in the healthcare system, including:
- Difficulty finding knowledgeable healthcare providers who work with transgender youth
- Difficulty for young adolescents in accessing hormone therapy
- Staff and providers not using preferred names or pronouns
- Being made to feel uncomfortable by the healthcare system
Tai and his mom have suggestions for how healthcare can better serve transgender youth. Tai says that being transgender should not color the entire patient experience.
“As much as any clinician can, they ought not to make being transgender a monumental issue when treating patients,” said Tai. “Yes, it’s a big deal to come out and realize you are transgender. But it becomes a part of the life you have, and you are a whole person beyond this one facet.”
His mom suggests that wellness check-ups for kids are a crucial opportunity to discuss sexual and gender questions in a safe space between patient and doctor.
Tai also emphasizes that language matters. In the patient’s chart, providers and staff should be able to see preferred name and pronoun. Recent changes to patient recordkeeping systems at Seattle Children’s allow clinicians to note patient gender pronoun preferences.
Tai says that clinicians can also ask the right questions to create a comfortable environment for discussion.
“My primary care doctor made it a very inclusive experience,” said Tai. “The doctor would ask, ‘Are you sexually active with males? Females? How many partners have you had?’”
Finally, access to information is important. Discussion about sexuality and gender might not come easily to young people. Tai suggests that hospitals should offer information online and in brochures in waiting rooms so young people can learn on their own terms.
Tai is at Evergreen State College now, and even though that’s a big step into adulthood, he feels it’s important that healthcare providers learn from his experience as a transgender youth.
“I’m fortunate to be working with the medical team here at Seattle Children’s, where the staff is actively working to improve the healthcare experience for transgender youth,” said Tai. “There is still a lot of room for improvement in the healthcare system. However, through the tireless dedication of medical professionals who want to achieve healthcare access for everyone, all the right conversations are happening and are very much alive.”