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Feb. 27 (UPI) -- What's in a name? When young transgender people seek healthcare services, how physicians refer to them can affect their comfort level -- which influences whether they receive proper care. Nearly 80 percent of transgender youths want electronic medical records, or EMRs, to reflect their preferred names and pronouns, according to a survey published in JAMA Pediatrics this month.
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"Most transgender youths in this study use a name that is different from their legal name and want their affirmed name and pronouns clearly documented in electronic health records," Kacie Kidd, a fellow in adolescent and young adult medicine at the UPMC Children's Hospital of Pittsburgh, told UPI. "Few are given the opportunity to discuss this critical part of their identity outside of specialized gender centers."
A study published in February, also by Kidd and her colleagues, showed more than half of transgender youth feel uncomfortable sharing their gender identity with healthcare providers over fears they will be stigmatized. For many, this anxiety means hesitance to pursue necessary medical treatments.
A spokesman for the American Medical Association told UPI that the organization's policy stipulates that "physicians must create a setting that is safe and inclusive to meet the health needs of the LGBTQ population."
To support the policy, the AMA offers member physicians educational resources and advocacy information to assist in ensuring their practices meet the standards. In November, the AMA also implemented a new EMR policy that calls for "voluntary inclusion of a patient's biological sex, current gender identity, sexual orientation, preferred gender pronoun(s), preferred name and clinically relevant, sex specific anatomy" in all records, including EMRs.
However, advocates for the LGBTQ+ community said much work remains to address this and other issues that effectively serve as barriers to care.
"We're in the middle of a coronavirus pandemic -- we cannot afford to have a segment of the population afraid to get treated because they feel the medical staff will be rude or discriminatory," Tori Bertran, director of youth services at SunServe, a Fort Lauderdale, Fla.-based organization that provides support and professional mental health services to the area LGTBQ+ community, told UPI.
Beltran said SunServe provides guidance for transgender youth on how to advocate for themselves when visiting healthcare professionals by being "firm, polite and brave." The group also offers education on rights and protections at the national, state and local levels.
"More importantly, we refer out to LGBTQ+ competent doctors who have a record of working with our community and who we know will treat our folks with respect," she added. "For example, we know of a local OB/GYN who closes her office one day a month and only schedules transgender men on that day."
In the survey of 204 transgender youths, 69 percent of respondents used a name different from their legal name. However, just 4 percent of respondents had completed the legal name change process at the time of the survey.
In all, 79 percent of respondents said they would prefer to have both their name and pronouns documented in EMRs, while 92 percent of non-binary youth -- those who don't identify as either male or female -- indicated they would like their name documented.
Among those who did not desire EMR-wide documentation of preferred names or pronouns, 86 percent said that because they already "passed" they did not feel name or pronoun documentation was necessary. Notably, just one participant raised concerns about confidentiality, while 8 percent of those surveyed were always or often asked if they wanted to have their name and pronouns documented in their EMRs.
"It is incumbent on healthcare professionals and health systems to create a climate that allows transgender patients to feel comfortable, and using features within electronic health records to affirm patient names and pronouns is a big part of creating that inclusive environment," Kidd said.
