Designing a Better Health System: Patient Perspectives on Gender Inclusive Care

Our study explored perspectives of transgender and non-binary (TNB) patients regarding gender-inclusive care at our medical center. Thirty participants (13-21 years old) completed semi-structured interviews and demographic surveys. Surveys were analyzed using descriptive statistics, and interviews were analyzed using thematic analysis. Key themes contributing to positive experiences were: (1) personnel with experience caring for TNB youth, (2) Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA) identified health care team members, (3) visible improvements made over time, (4) provider and staff advocacy, and (5) parent advocacy. Areas for improvement were: (1) training on use of pronouns, gender-affirming terminology, and exam techniques, (2) accurate display of name and pronouns in the electronic medical record and patient labels throughout clinical settings, and (3) more LGBTQIA-inclusive décor and resources. While improvements were recognized, participants identified persistent gaps. Multilevel advocacy and standards set by accrediting bodies can be the next steps in ensuring quality care for TNB patients.