Transcription:
Transgender Care: Creating Communications and Engagement Guidelines

Bill Klaproth (Host):  On this edition of the SHSMD Podcast, we talk about transgender care, creating communications and engagement guidelines. So, what are the challenges transgender patients face when seeking care? What are the best practices related to patient engagement and training? And what is the best approach for coming up with a plan to serve this community? Really good questions. But don’t fear, we’ve got really good answers. So make sure you listen to this podcast all the way to the end. We are going to get you those answers right now.

This is the SHSMD Podcast, Rapid Insights for healthcare strategy professionals in planning, business development, marketing, communications and public relations. I’m Bill Klaproth. And in this episode, we talk about transgender care, creating communications and engagement guidelines. And with me is Aleks Golota, Amy Sarah Marshall and Sarah Ridgeway, all with the University of Virginia Health. Aleks Golata is a marketing and PR specialist. Amy Sarah Marshall is an online content strategist and Sarah Ridgeway is a marketing and PR specialist. Aleks, Amy Sarah and Sarah, welcome to the SHSMD Podcast. Now as you know, we start every episode of the SHSMD Podcast with Rapid Insights. One quick tip someone can use to make their marketing communications better today. Amy Sarah, you’re up first. Give us your Rapid Insight.

Amy Sarah Marshall (Guest):  All three of us believe that developing empathy is the most critical aspect of a marketing strategy. And so, my quick insight is to go ahead and develop two to three authentic relationships with people who fit the demographic of the people with whom you are trying to communicate so that you can do a quick gut check with them on your communication style and approach and make sure that you are not out of step. And Sarah?

Sarah Ridgeway (Guest):  So, yeah, just like Amy Sarah said; developing that empathy before you get to task master project mode. Spend some time on those Aliant websites or the organizations that is actually supporting that patient population. You could sign up for their weekly distribution emails, you could follow their social site and that really helps you like Amy Sarah said, get familiar with that language that that patient population uses and then those issues that actually matter to them. Aleks?

Aleks Golota (Guest):  Yeah, and I would just add that getting to know your audience is one of the important things when it comes to marketing. Try to walk in their shoes. Find out exactly what it is that they are needing and wanting to hear, and I think you’re going to be more successful as a marketer when you are doing those things.

Host:  And that is a great Rapid Insight. Really some good information there ladies. And thank you again. So, Amy Sarah, I’m going to start with you. So, let’s dig into our topic a little bit more here. So, can you share with us general transgender terminology and demographics that we should understand?

Amy Sarah:  Absolutely. So, in the United States, there’s about 1.6 million people who identify as transgender. If you know somebody who is a natural redhead, that’s about the same percentage of the population as people who are transgender. So, if you know a redhead, you probably know somebody who is transgender. The term refers to your identity as you understand it internally. So, if you are born and physically you look like you belong to the gender of being a girl or a boy; we say that doctors assign that gender to you because of biological sex, although there are people who are not necessarily one or the other because they are intersex but if you are told you are a boy and you have the physical characteristics of a boy; but internally you understand yourself to be a girl; then that is when you are transgender.

Every single human being as you develop part of our human process is to develop a sense of our gender identity. It’s not something that you are born with. Everybody develops that as part of their normal growth and people who are transgender have an identity that is different than what their biological sex is. And so, that’s where the transgender terms comes from. If you don’t have a difference, there; you are cisgender which comes from the Latin cis which means same. So, that’s where the distinction is.

Host:  So, knowing that it’s a lot more common than we think, really helps us to understand that this community has been discriminated against and underserved as a population. So, that leads us to the next question. Aleks, what are the challenges then transgender patients face when seeking care?

Aleks:  Yeah, that is an excellent question and I feel like challenges, there are many. I’ll just touch on a few. So, oftentimes, we believe that caregivers don’t have an opportunity to understand their trans patients and the medical issues that they might be dealing with. So, often enough, the appointments for medical care that the trans patients come to are spent with their care providers being educated instead of patients being treated. Another issue and challenge is that the care givers are lacking training in terminology and policies when it comes to transgender patient care.

And in many organizations, there are no policies by which the trans population can be backed with in order to receive proper care. So, unfortunately, there is a lot of discrimination and lack of proper medical care when trans patients come to doctors to seek medical attention.

Host:  Well I’m happy the LGBTQ community is finally getting recognized and policies are being put in place, so these people receive the proper care they deserve. So, Sarah, knowing what Aleks and Amy Sarah just discussed; let’s talk about how to address this. What is the distinct approach that should be taken in order to care for transgender patients?

Sarah:  Yeah, that’s a very loaded question. Because there’s obviously many approaches other medical centers have taken that are through our research, we’ve found that really even if you are providing transgender services to patients at that very moment; it is extremely important that you align your services internally before you take it externally to market. We have not provided this stat yet, but 40% of transgender individuals will attempt suicide in their lifetime so it’s a very, very sensitive population. So, they really will enter this system in so many ways. So, that’s why it is so important to align internally. So endocrinology urology, plastic surgery, behavioral health; trans patients could be entering at any moment. So, really before you start promoting those services to your community, to your state; we recommend getting sort of a transgender advisory committee that is very patient centered so if you can reach out to LGBTQ community members or if there’s internal employees that have identified as transgender who are willing to share their experiences and finding some folks on the clinical side who have proven to be strong allies and sort of aligning everyone internally before you make sure that all of that content and all of this marketing materials you are putting externally is truly representative of the experience they are going to have at your medical center.

Host:  I think that’s really great advice. Align your services internally before you take it externally. I think that’s really important point and I love –

Sarah:  Yes, it is so important.

Host:  And I love how you talked about the transgender advisory committee as well. I think that’s really, really important. So, Aleks, let me ask you this. What then are the best practices related to patient engagement, training, policies, communications and clinical care?

Aleks:  Yeah to connect this to Sarah’s answer just a few minutes ago, yeah, making sure that internally, the medical staff is trained and that could begin with the receptionist and anyone who comes in with patient interaction at the beginning. Folks who answer the phones, they know how to use the pronouns and what the pronouns are, they can explain to the trans population how to navigate the healthcare system, what services they might be looking for, what providers might be safe space providers and who have been trained and know exactly what’s going through the trans person’s mind when they’re accessing the healthcare system.

I think those are all really good important points.

Amy Sarah:  And making sure that it’s required.

Aleks:  Yes, thank you.

Amy Sarah:  That is a key part and that is and like you mentioned, making sure that it’s not just the clinical staff who are trained but everybody in the environment where healthcare is being provided. Because they all effect the experience. And whether or not a transgender person feels safe or not.

Aleks:  And I think some of that is going dismay the bias that is out there in regards to the trans population.

Host:  Yeah, that makes sense. So, you’re saying once more providers come on board providing that safe place if you will, more providers will see that and start to incorporate that into their practices as well. Is that right?

Aleks:  That is it exactly.

Host:  So, Sarah, how should we then develop a plan for changing an organization’s culture to address transgender care?

Sarah:  Yeah, it depends on your organization’s size obviously. It can be more challenging the larger you are and depending on where you are demographic wise obviously cities have a much easier time because they have a tendency to be a little more forward thinking. We are in the south, so it does come from sort of the grassroots work which is why we are participating in this today’s podcast. We are in the marketing department and we feel this population has been underserved and we wanted to help lead the charge. So, starting with that transgender advisory group, just a couple of thoughts if you were putting that together. Making sure that you meet sort of people where they are comfortable, that you can provide sort of opportunities for anonymous input from outside influencers whether they are patients or employees. And we can’t take feedback personally or defensively. And you really need to give people a chance to review any sort of materials or policies before you put it in front of them. And you have to expect that it’s going to take time. When you are trying to gather a group of people who have fulltime jobs or part-time jobs, you need to be respectful of the time that they’re committing to your advisory group.

And you can’t rush it. It is definitely not something, this is not a patient population that can be sort of just a quick fix and a quick services page on your website and move on. It is something that takes time and is changing and it’s important that the folks on that committee recognize that.

Host:  And Amy Sarah, did you want to add something in?

Amy Sarah:  Yeah. I just wanted to say in terms of changing your organizational culture; that that a lot of people will think that they can develop an antidiscrimination policy and – but if people don’t know about the policy, if people aren’t reminded of it and I’m talking about both staff and patients; the policy doesn’t really have any heft to it. So, you have to make sure that you’re educating about policies, that you are posting them publicly, that you are keeping any decisions you make about how you are going to approach this population very explicit and very visible. So, that every clinic has that policy so that if you are putting rainbows up to show that you have had training and that you are providing these services; that those are visible to everyone. Part of the issue with treating trans patients is that there’s often an invisibility there and that things are kept sort of under a layer of cultural shame so to speak.

And so, unless we create an environment where the welcome is explicit; you are not going to actually change the culture. And you are going to also need to have champions who are modelling the behavior you would like other people to show. So, you are going to need to find leadership who are willing to use the correct pronouns and just model that behavior.

Host:  Well those are really good points. You do have to attack this at a deeper level. This is more than just changing a page on your website. And you also talked about the importance of the leadership modelling the correct behavior that you want people to emulate. So, I think those are really important points. So, Amy Sarah, let me stay with you. On a personal level, there still may be some biases among individuals toward a transgender patient within the healthcare setting. What approach should be taken to help train those individuals to boost empathy and understanding towards transgender patients?

Amy Sarah:  Yeah so, we don’t advise trying to force somebody to change their hearts and minds or beliefs or value systems when it comes to interacting with people who are trans. What we advocate however, is that people subscribe to and be encouraged and trained in how to be respectful. We want to – everybody who is in healthcare is there for a reason and usually those reasons have to do with helping other people and providing care. And so, the setting the expectation that there is a foundational shared base way that we treat people is really key.

I think that everything that we have learned about how people develop empathy, has to do with exposure and interaction and those personal relationships that occur. Those kinds of relationships and interactions can only happen at an authentic level if there’s a basis of respectful behavior between those individuals. So, it really comes down to having those in person trainings, allowing people the freedom to ask questions that they may need to ask or have the freedom to have whatever feelings they have but then asking them to still treat whoever walks through the front door of that clinic or hospital with the same amount of respect. And for transgender people, that means using their correct names, their correct pronouns, looking at any implicit bias that you may be expressing and then moving on from there.

Host:  I think that’s a great way to look at it. We all need to provide that foundational base of care. I think we should all be aspiring to that because to me, this isn’t going away. This population has always been there, but it has been underserved and today, I think our younger generation and hopefully more of us are more open to sharing and understanding and accepting the transgender community. So we all should be thinking of this. This isn’t just a phase that people are going through. These people deserve the same care and respect we all get and that again speaks to the foundational base that Amy Sarah was just talking about. So, Sarah, can I get your thoughts on that and maybe you can wrap this up for us.

Sarah:  I think that what you just said Bill is kind of relevant in the sense that a lot of people have this misconception that it’s a trendy thing and that it’s something the kids are doing when really it’s not that, it’s actually folks are now having the words and the content to sort of express themselves and feel safe to come to terms with their actual gender identity, that they’ve been feeling for their entire lives.

So, I think it’s important for folks to say that they are thinking that it is just a phase that the use – just talking about sort of the coming of the next five to ten years about how gender fluidity is becoming a part of sort of that younger culture’s life and that medical centers need to be prepared to receive them.

Host:  And Amy Sarah?

Amy Sarah:  I think that we have to provide care for all. We can’t pick and choose who we want to provide care for. And so I think any healthcare organization needs to take the responsibility of learning about who they are serving. And especially for this population who have been so vilified and experienced just a lot of oppression and bias and still experiences a lot of that in their daily lives to this day and face a lot of healthcare challenges that include stress, and emotional problems so, I think it’s incumbent on all of us to learn how to be welcoming to this population.

Host:  Very well said and I think this is a timely topic. Aleks, Amy Sarah, and Sarah, thank you for your time.

Amy Sarah:  Thanks Bill.

Aleks:  Thank you Bill.

Sarah:  Thanks Bill.

Host:  And please join us for SHSMD Connections 2020 where you can learn more about healthcare strategies specific to marketing, digital engagement, communications, public relations, strategic planning, business development as well as career and leadership development, this year September 13^th through the 16^th 2020 in beautiful Chicago, Illinois. And to learn more about SHSMD, visit www.shsmd.org and please subscribe to this podcast and check out upcoming SHSMD education events by heading over to www.shsmd.org/education. That’s www.shsmd S-H-S-M-D.org/education. This has been a production of Dr. Podcasting. I’m Bill Klaproth. See ya.