Transgender and Gender Nonbinary Patient Experiences in the Emergency Department: A Regional Study

Area of Science:

• Health Services Research
• Health Equity
• Transgender Health

Background:

• Transgender individuals report significant discrimination in healthcare settings.
• This discrimination leads to avoidance or delayed emergency department (ED) care.
• Emergency physicians receive inadequate training on transgender patient needs.

Purpose of the Study:

• To investigate the ED experiences of transgender patients in the Portland metro area.
• To assess the knowledge and training of OHSU ED staff regarding transgender care.
• To identify factors influencing transgender patient experiences in EDs.

Main Methods:

• Surveys were administered to transgender individuals accessing ED care and OHSU ED staff.
• Data analysis focused on identifying trends and predictors of positive ED experiences.
• The study examined the relationship between staff training, role, practice duration, and self-reported proficiency in transgender care.

Main Results:

• The opportunity for patients to provide pronouns at check-in was linked to improved perceived ED experiences (p<0.01).
• Significant differences were found between reported best and worst ED experiences for transgender patients (p<0.01).
• ED providers with formal transgender health training reported higher proficiency, independent of practice length.

Conclusions:

• There are significant disparities in ED experiences for transgender patients, highlighting areas for improvement.
• Implementing pronoun options at check-in is a key recommendation for enhancing patient care.
• Mandatory transgender health care training for ED staff is crucial for improving the quality of care and reducing discrimination.