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09/30/2015 01:38 pm ET Updated Sep 30, 2016

Tactless Medical Staff Are Scaring Trans Patients Out of E.R.

By Tracy Clark-Flory

The story of one transgender man's mistreatment in the emergency room is prompting nurses across the U.S. to change how they interact with transgender patients. A few years ago, a 40-something transgender man went to his local emergency room with a case of severe anxiety -- but the treatment he received was anything but calming. After giving the check-in staff his driver's license, which identifies him as female, he was soon flanked by several nosey ER workers. "They come up and she's like, 'That's a girl.' Pointing at me saying, 'No, that's really a girl,'" he says. "It wasn't business-like at all. I was a spectacle. I was a freak show at the circus. It was definitely to draw attention to the fact that my outward appearance didn't match [my identification]."

After he waited for several hours, another staff member repeatedly called Brandon James (whose name was changed in the article) "Ms. James," even after being corrected. "She was blatantly being disrespectful," he says. "Can't you just call me Brandon? Or just call me Brandon James? They were real hesitant to do that." Ultimately, James left without even seeing a doctor -- and that's a huge issue.

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The paper's authors argue that poorly trained staff members, like the ones James encountered, discourage transgender people from getting vital healthcare. "The scarcity of clinical providers adequately prepared to care for transgender persons is a major barrier to seeking care," says the study. "In addition, some transgender people encounter denial of services, discrimination, harassment, and even violence in health care settings."

This story, which uses a pseudonym for James, calls to mind a trans woman who gained national attention last week by live-tweeting her horrifically poor treatment by airport security. But this tale comes from a much more old-fashioned source: a medical journal. The new study published in the Journal of Emergency Nursing uses James' experience as a case study, and recommends best practices for adoption in emergency rooms when treating transgender patients. Those practices include some seemingly self-evident advice: ask people for their preferred pronoun and then -- here's the important part! -- actually use that pronoun.

Past research has borne this out. In 2011, the National Center for Transgender Equality and the National Gay and Lesbian Task Force surveyed hundreds of transgender men and women. The study found that half reported ignorance on the part of healthcare providers about trans people and 19 percent said they were refused medical treatment because of being trans. When it came to the emergency room in particular, 13 percent said they were denied equal treatment and 16 percent reported being harassed. The current report draws a direct line between the "high lifetime suicide rate in the transgender community" and this poor treatment, but also the fact that some transgender people avoid routine healthcare as a result.

There is some good news to report here, though. The paper, and James' story in particular, has inspired the Emergency Nurses Association to come out in support of the recommended policies. "Emergency nurses are on the front lines of treating more and more transgender patients," said the organization's president, Matthew F. Powers. "All patients must be treated with dignity and respect."

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