• Elijah Castle

healthcare self-advocacy

It can be difficult for many reasons for transgender and non-binary (TGNB) peple to advocate for ourselves in healthcare setting. Speaking up in a situation where there is an obvious power dynamic, such as when speaking with a medical provider, can be hard! We may be afraid of advocating for ourselves because it could mean a provider refusing to treat us.

It is important to remember that provider-patient relationships should be and feel collaborative. This means we as patients should have an equal amount of control and say in the relationship with our medical provider - whether that is a physician, nurse practitioner, a physical therapist, etc.

This is where self-advocacy comes in. Self-advocacy means speaking up for our own self-interest and being an active participant in decisions that directly affect us.

Self-advocacy is not a skill that is only beneficial for trans people - this is helpful for disabled people, BIPOC, and anyone else with a marginalized identity.

Here are some instances where it is important to advocate for ourselves:

When a provider misgenders us or uses the wrong name…

If we have told our provider our chosen name and pronouns and they use something different, we can remind them.

If they continue making mistakes or intentionally using the wrong name or pronouns, we should find a new provider. We can find trans-friendly and -competent providers through local LGBTQ/trans organizations and pride centers.

When a medical provider uses words for our body that makes us uncomfortable…

For example, if a provider uses the word ‘breast’ and we prefer ‘chest,’ it’s okay to tell them!

It can also be helpful to give this information at the beginning of the appointment, but it is also okay to tell them in the moment.

When receiving any kind of treatment…

We can ask the following:

  • What is the purpose of this treatment?

  • How will this affect my overall health?

  • Are there any side effects?

  • Will it interact with any of my current medications?

  • Will this involve any kind of routine testing/screening?

When a medical provider recommends a treatment or procedure we are not comfortable with…

Example 1) A surgeon recommends a procedure that would result in an outcome we are uncomfortable with. It is our right to voice this and/or get a second opinion.

If the procedure being discussed is gender-affirming surgery, then it is prudent to note that having surgery can mean making compromises, and the outcome may not be exactly what we wanted. Regardless, it is important to feel understood by the surgeon so that they are an active part of educating us and informing us why certain decisions may need to be made.

Example 2) A provider tells us to lose weight. Ask:

  • Why? What health indicators need to be improved?

  • Are there any alternatives?

  • Can I go for walks to improve my cardiovascular health? Etc…

  • (If we really like research and data) What research can you show me that states weight loss will directly improve my health?

When we have questions our medical provider did not answer…

Medical appointments can move very quickly!

Sometimes we are still left with questions we forgot or were too nervous to ask.

It is okay to ask for a phone call or another appointment with the provider. It is also okay to ask if we can communicate in a way that makes us feel more comfortable - for example, using email instead of a verbal discussion.

If a provider refuses to answer our questions or is dismissive, that’s a red flag.

Part of a medical provider’s job is to educate us about the care we are seeking. Hold them to this!

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