Equality Arizona

International Day of Transgender Visibility – Discrimination in Healthcare

This blog post is part of an ongoing series on transgender issues authored by EQ AZ Board Member Juli Myers.

 

After signing in and verifying that my information had not changed since my last visit, I sat in one of the six metal-frame upholstered chairs and stared at the striped beige wallpaper in front of me. It was torn at the top corner near the molding of the reception door, which opened after a few minutes.

“The doctor will see you now.”

I walked through the door and made the left turn without having to be told and stepped on the scale. Standing to my left, she adjusted the weights, the top one to 200 and the bottom one towards the center. Smiling as she pulled her arm from in front of me, I guided the black metal piece out to nearly the very end before balance was achieved. Looking over her glasses with a well-practiced tsk-tsk, she wrote the number down before waddling hypocritically down the hallway and guiding me into the second room on the left.

My vitals taken, she looked down at the chart again to see the reason for my visit. “Let’s see, you’re here today to…” She looked up and took me in. Rising, she left the room with an abrupt, “The doctor will be in shortly.”

The plastic wall rack behind me was full of wrinkled and torn magazines that predated the Clinton administration, and the only other reading material was a children’s bible with all but two of the order forms inside the front cover torn out. I’ve never understood why medical offices have these in the exam rooms. “Well, Billy, that’s a good question. Turn to page 60 and start reading the second paragraph. See? Your mother was right; you really can go blind.”

In the midst of pondering this, the doctor came in. I’ve been seeing him for a few years, and we have always had a pretty cordial relationship. He asked about the kids and my wife, and I asked about his. After glancing at the handwritten note with my vitals, he turned to wash his hands while reciting a speech I knew from memory, something about my blood pressure, my weight, and having seen me coming out of IHOP the week before. My part in this play was to look down at the ground and be ashamed, and I had actually managed to figure out how to make myself blush while doing it. We could really tour with this act.

His hands dried, he picked up the chart and looked it over more closely. Sitting down, he took off his glasses and sighed before ripping the Band-Aid off quickly. “I can’t treat you anymore.”

“Why? I’m all paid up, and I’ve been coming here for four years.”

“I’m afraid I can’t treat your kind. I don’t know anything about it. Frankly, I don’t agree with it,” he said in a voice the coldness of which I had never heard before.

“But…” I sputtered.

“I’m sorry. This is a small town, and you know how people are. Besides, are you absolutely certain you want to do this? Have you talked to anyone about it?”

“Well, I’m talking to you,” I answered.

“It’s just… I’m not comfortable treating diabetics.”

“C’mon, Doc. My blood sugar has been in the 800s for weeks now. I’m tired all the time, and I nearly passed out this morning. I need insulin!”

“Well, there’s only one thing I can do,” he snapped, scribbling something on the prescription pad, tearing it off and handing it to me, “Give him a call.” I looked down to see that he had written the name of his pastor. Then, he left the room.

A tear started to fall down my cheek. I wiped it off as he returned to the room with a box of Hershey bars, which he set down next to me, instructing me to eat three with each meal. Walking past me to the plastic rack on the wall, my former friend pulled out the children’s bible.

“Here,” he said, “Spend some time with this, too.”

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According to the landmark study Injustice at Every Turn: A Report of the National Transgender Discrimination Survey (published by the National Center for Transgender Equality and the National Gay and Lesbian Task Force), an astounding 50% of transgender people surveyed stated that they had to teach a medical provider about their condition, while 28% reported harassment in medical settings, and 19% reported that they had been turned away by medical professionals because of their gender identity.

Like the doctor in the anecdote above, most medical professionals who refuse to treat transgender people (such as the author’s own) cite unfamiliarity with gender dysphoria due to its relative rarity. On its face, this might seem like a plausible excuse. Accurate numbers are difficult to come by. I have seen statistics that report us as comprising as little as 0.4% of the general population, but according to a fact sheet from the Transgender Law Center, an estimated 2-5% of the general population experiences some sort of gender dysphoria. Fear of self-reporting, fear of facing one’s gender dysphoria, and the alarmingly high rate of suicidal ideation/attempts (estimated to be at approximately 50% for the transgender population) lead one to assume that the higher number is probably more accurate.

To put that into perspective, the number of diabetics in the general population is only about 9% – just a few points higher than trans people. Fibromyalgia suffers number approximately 2% of the general population, celiac disease sufferers 1%, 1.4% for those diagnosed with leukemia, and 0.25 to 0.4% for those born with cerebral palsy.

We don’t hear about people being turned away from doctors when they present for these statistically rare conditions for one simple reason: they are believed. Transgender people, on the other hand, are not, and what’s worse, a physiological condition is all too often filtered through a moral, rather than a medical, lens.