Half of transgender Ontarians do not feel comfortable with their family doctorApproximately half of transgender Ontarians who have a family physician are not comfortable discussing transgender-related health issues with their family physician.
Greta Bauer, PhD, associate professor in the Department of Epidemiology & Biostatistics, led the study examining the factors associated with transgender patients’ access to and comfort with family physicians.
Of transgender patients with family doctors, 47.7 per cent of transmasculine and 54.5 per cent of transfeminine patients reported that they were not comfortable discussing transgender issues with their family doctor.
Issues which impacted a patient’s level of discomfort with their family physician included whether they perceived their doctor was knowledgeable about transgender-related issues, their medical transition status, previous marital status, and negative experiences with family physicians.
“Universal access to health care is a tenet of our health care system, but in reality, not everyone has true access to the same level of health care,” said Bauer. “All patients need to feel comfortable with their doctor, otherwise there are barriers to accessing care – whether it’s for medical transition-related care or bronchitis.”
Having a physician who was perceived to be “somewhat to very knowledgeable” about transgender-related issues was associated with a 38 to 63 per cent reduction in the risk of feeling discomfort with their physicians.
Transmasculine patients who either had not started a medical transition or decided not to medically transition were 56 per cent more likely to report discomfort than their peers who had completed a medical transition.
Transfeminine patients who were previously married had a 49 per cent increase in discomfort with their family physicians. In contrast, transmasculine patients who had been married had a 52 per cent reduction in discomfort with their family physicians.
More than a third of transmasculine and transfeminine respondents – 37.2 per cent and 38.1 per cent respectively – reported a transgender-specific negative experience with their family physician. Transfeminine respondents who previously experienced three or more negative experiences specific to being transgender were 2.26 times more likely to report feeling discomfort with their current family physician.
Negative experiences included family physicians who had refused to see the patient or ended care because they were transgender, used hurtful or insulting language related to being transgender, told the patient they were not transgender, discouraged the patient from exploring gender, stated that they did not know enough about transgender-related care to provide it, belittled or ridiculed the transgender patient, thought the gender listed on the patient identification was incorrect, and refused to examine parts of the body.
The study also found that transgender patients were less likely to have a family physician, compared with the general population in Ontario – 83.1 per cent and 90.9 per cent respectively.
Data was collected through the Trans PULSE Project (Trans PULSE) – a community-based research project initiated by Bauer and a broad group of academic and community colleagues in 2005 – that is investigating the impact of social exclusion and discrimination on the health of transgender people in Ontario. Trans PULSE was funded by the Canadian Institutes of Health Research. This study specifically looked at Ontarians aged 16 and older who identified as transgender. It has been estimated that there are approximately 53,500 transgender adults in Ontario.
The article can be accessed online at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145046