Research Project Aims to Improve Care for Transgender and Gender Diverse Patients
A research project by Regina physicians that aims to improve care for patients who are transgender and gender diverse (TGD) was recently recognized as the best project from a resident of the College of Family Physicians of Canada – Emergency Medicine (CFPC-EM) program at a local research day.
During the University of Saskatchewan’s Emergency Medicine Research Day, Drs. Lisette Christopherson (she/her) and Aryan Ashou (he/him) received the CFPC-EM Research Award for their project, “Assessment of knowledge, attitudes, and skills working with patients who are transgender or gender diverse of Saskatchewan emergency physicians and emergency medicine residents.”
“I’m grateful the judges realize what an important area of study this is, and I’m proud that our project may lead to future learning and positive change within our ERs,” says Christopherson, who is motivated to improve healthcare experiences for those in the 2SLGBTQ+ community, including her sister.
“I have a huge amount of privilege, and I’m using it to try and make a meaningful difference.”
People who are TGD report suboptimal quality of care when interacting with healthcare providers. A 2019 Trans PULSE Canada National Survey found that in addition to having unmet healthcare needs, people who are TGD avoid the emergency department out of fear of mistreatment. Christopherson says this adds to a growing body of literature in North America that highlights two interconnected issues:
- Patients who are TGD are not receiving culturally safe care
- Healthcare workers lack comfort and specific knowledge to appropriately care for patients who are TGD in a culturally competent way
This project set out to answer the question: Do emergency physicians and residents within Saskatchewan lack the same comfort and knowledge when caring for patients who are TGD?
A survey was distributed to emergency physicians and residents in Saskatchewan, which we recognize as the traditional territory of the First Nations and Métis people, to assess their comfort and knowledge of treating patients who are TGD.
Fifty-eight physicians completed the survey, with 22.4% (13) reported having previous training on transition-related healthcare. The majority of participants reported they had provided care to a patient who was TGD (93%, 54), with most feeling comfortable establishing rapport (88.9%, 48), addressing patient needs (90.7%, 49), and providing non-transition related medical care (96.6%, 56).
One physician reported that they had "noted on the patient's chart that there was a flag they were transgender, and I made a point to ask their pronouns and preferred name to ensure I was addressing the patient correctly, which they seemed to be very appreciative of. (It seemed like it was a rare thing for the patient to be asked).”
"Using their preferred pronouns/acknowledging their gender identity is important to not cause additional harm during patient care,” added another.
Consistent with other studies, few participants had any formal training on transition-related healthcare; however, participants reported high levels of comfort in their interactions with TGD patients, which Christopherson says is encouraging compared to previous studies. She says case questions assessing knowledge of risk factors and lab abnormalities showed a similar knowledge gap seen in other studies, adding that the vast majority of physicians welcomed more training.
“One of the limitations is this study is from a physician standpoint, the side we might expect to be more comfortable. Although physicians are expressing this comfort, this doesn’t look at the patient side,” acknowledges Christopherson. “I would expect patients aren’t as comfortable as healthcare providers based on previous studies. But I think this is a good starting point.”
In addition to studying the patient’s perspective, Christopherson says there is also a need for further studies that would assess the change in physicians’ knowledge and comfort before and after education.