By Jackson DeBorde
The United States is recognized as having one of the world’s most advanced and personalized healthcare systems; however, the nation severely lacks in many fundamental areas of modernized medical care. While physical outcomes of health care are certainly important to determining a person’s overall health, mental and environmental health components of medical care are equally important.1 As the nation continues to move forward to support the accommodation of these aspects of everyday life, healthcare providers will need to as well. Recently, it has become evident that certain groups of patients are not receiving equitable treatment from their healthcare providers, which is causing some patients to delay or even avoid seeking care altogether.
“Deadnaming” is the act of referring to a transgender or non-binary person by the name they used prior to transitioning.3 Deadnaming can be very harmful, even if it happens accidentally, as it can give the impression that a transgender or non-binary person is not respected. The act can also cause extreme stress for a transgender or non-binary person, as it can remind them of a traumatic time in their life before they could express their true gender identity. This feeling, known as gender dysphoria, has been known to be associated with depression and anxiety in transgender and non-binary patients.4,5 For these reasons, many transgender or non-binary patients avoid seeking medical care for fear of being deadnamed by their healthcare providers.2
I spoke with Skye Baker, a young transgender man from Texas, about his experiences with deadnaming in healthcare settings:
“I am constantly deadnamed [in healthcare settings] as I don’t have my name legally changed, and I fear that this will cause me some trouble in getting care. If it wasn’t for me being chronically ill, I would have contemplated not seeking healthcare for the sake of the dysphoria of my deadname being shouted across the room.”
For those who possess a deadname, a major issue arises at healthcare centers when their updated name or appearance does not match the name on a government-issued ID. According to the 2015 U.S. Transgender Survey, 33% of individuals that visited healthcare centers with IDs that did not match their gender presentation reported being verbally harassed, denied services, and even refused treatment by healthcare providers.6 Some respondents even reported that they had to educate their healthcare provider about transgender people in order to receive appropriate care.6 The survey additionally found that 23% of respondents did not see a doctor when needed due to fear of being mistreated.6
As a result of this hesitancy towards healthcare settings, transgender patients report having higher rates of “fair” or “poor” physical health compared with cisgender patients.6 Additionally, nearly 40% of transgender people have been found to experience serious psychological distress, which is almost eight times the average rate of the U.S. population.6 This evidence suggests that the discrimination that transgender people encounter when attempting to access healthcare may contribute to their increased susceptibility for both physical and mental health conditions.6
To eliminate the disparities suffered by the transgender and non-binary communities, the United States must prioritize policies that enable these groups to feel safe and welcome when seeking medical care. This can begin with legislation that allows patients with a deadname or preferred name to make this information immediately known to their healthcare providers, and it can specifically require that their providers only use the patient’s preferred name from that moment forward. The legislation should also include requirements that a patient’s preferred name must be updated on all medical records, with a note for the patient’s healthcare providers that the individual has an updated name that differs from the one used previously–the patient’s deadname. Intentional and continued failure from a provider to use a patient’s preferred name should result in a medical malpractice violation, as the intentional refusal to respect the wishes of a transgender or non-binary person can lead to the aforementioned detrimental impacts on physical and mental health.6
Of course, this would be a tiny step in the efforts to abolish the discrimination suffered by transgender and non-binary patients in healthcare.7 However, if policies supporting transgender and non-binary patients are prioritized, the country may soon see a positive change in healthcare outcomes for these communities. This policy would allow many patients to feel much more comfortable in seeking care and allow for the repairing and building of the relationships between providers and transgender and non-binary patients. If the United States is to truly become a modern and equitable place to receive health care, then our leaders must ensure all of its communities are given the opportunity to feel as though they are safe and respected.
References
- Learn About Mental Health – Mental Health – CDC. www.cdc.gov. Published December 12, 2018. https://www.cdc.gov/mentalhealth/learn/index.htm#:~:text=Mental%20and%20physical%20heal th%20are
- Holtz D. Why Transgender Patients Dread Seeking Medical Care and How to Change That | Samuel Merritt University. www.samuelmerritt.edu. Published April 3, 2019. https://www.samuelmerritt.edu/news/why-transgender-patients-dread-seeking-medical-care-and how-change
- Definition of DEADNAME. www.merriam-webster.com. https://www.merriam-webster.com/dictionary/deadname
- Parekh R. What Is Gender Dysphoria? Psychiatry.org. Published 2009. https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria
- What Deadnaming Is and Why It’s Harmful. Cleveland Clinic. Published November 18, 2021. https://health.clevelandclinic.org/deadnaming/
- James S, Herman J, Rankin S, Keisling M, Mottet L, Anafi M. The Report of the 2015 U.S. Transgender Survey. The National Center for Transgender Equality; 2016:81-92. https://transequality.org/sites/default/files/docs/usts/USTS%20Full%20Report%20-%20FINAL% 201.6.17.pdf
- Lee A. Transgender Discrimination in Healthcare | LLU Institute for Health Policy Leadership. ihpl.llu.edu. Published March 11, 2021. https://ihpl.llu.edu/blog/transgender-discrimination-healthcare