A new article by Yale researchers could change the way doctors treat their young transgender and gender-nonconforming patients.
The article, titled “10 Things Transgender and Gender Nonconforming Youth Want Their Doctors to Know,” will be published in the April issue of the Journal of the American Academy of Child & Adolescent Psychiatry as part of its Clinical Perspectives collection.
First author Jack Turban MED ’17 said he decided to write the article as a way to add more than just the “very clinical” language used to characterize transgender and gender-nonconforming youth within the scientific community.
“There’s not a lot coming from the kids and their own voices to tell doctors what they think is important. It’s been a lot of doctors saying what they think is important,” he said.
To seek out these perspectives, Turban collaborated with Tony Ferraiolo, who facilitates support groups for hundreds of transgender and gender-nonconforming teenagers in the New Haven area. Ferraiolo asked a support group of 20 teenagers aged 13 to 18 what they wished doctors knew about them. After selecting and editing their responses and writing a brief discussion section for context, Turban submitted the article for publication.
The article, which was formatted as a numbered list of direct quotes, recommended specific changes in practice, such as inquiring about preferred pronouns or mandating training for staff members at check-in areas, as well as more general statements, including “Nonbinary people exist” and “Let me know that you are on my team.”
Turban said the Clinical Perspectives are usually written by people who treat a certain clinical population to increase general knowledge, adding that his published article is not particularly “research-driven,” but rather works toward building a narrative.
Since the medical profession still views sex as unambiguous and fixed, clinicians are less likely to treat their transgender and gender-nonconforming patients respectfully, said Maria Trumpler GRD ’92, director of the Yale Office of LGBTQ Resources.
Likewise, Ferraiolo described the challenges faced by transgender patients in clinical settings.
“If they’re only focused on the trans, they can’t move forward,” Ferraiolo said. “Sometimes it’s his vagina and her penis, that’s just the way it is.”
Ferraiolo said he thought the article’s importance stemmed from its potential to give transgender youth a voice within the medical community that they did not have previously. Turban added that he hoped the article would help fight stigma and a lack of understanding of the trans community.
But Trumpler expressed skepticism about the immediate impact of the research.
“I don’t think quantitative research, or even this particular qualitative research, ever really captures individual experiences and individual needs,” she said.
Yale transgender and gender-nonconforming students interviewed said many of the teens’ recommendations resonated with them.
Hudson McCormick ’17 said they agreed with many of the teenagers’ recommendations. They underscored the importance of training all medical staff, not just doctors and nurses, and added that they have been referred to as their “dead name” — the name by which they had previously been known — by office staff at Yale Health.
Although they said they had not had an explicitly negative experience with a Yale doctor, SGH Gavis-Hughson ’19 said they have neither been called by their preferred name nor ever asked their pronouns during visits to the facility. Earlier this year, Yale Health came under criticism for its approval process of gender-affirming procedures.
Both students and Trumpler stressed that transgender youth often have an especially uncomfortable experience when seeking clinical care.
“I think for trans people there can be a lot of stress associated with having to go to the doctor because you don’t know how they’re going to interact with your transness,” Gavis-Hughson said, adding that being gender-nonconforming can add to this stress.
McCormick said it can be difficult to go for a medical exam and have to teach doctors about who you are in order to get the care you need, but they expressed cautious optimism about the potential impact of the article.
“Publishing this list of suggestions from trans youth in a medical journal is a good step, but I still wonder if doctors will listen,” McCormick said.