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People classified as trans by health-care providers may actually identify as male or female: study

Research shows that transgender people often face barriers to accessing health care, including lower rates of cancer screenings. Getty

People who have been classified as transgender or gender diverse by their health-care provider may not actually self-identify as trans, new research has found.

According to a study published Monday in the Canadian Medical Association Journal (CMAJ) about sexual orientation and gender identity data, some people prefer to identify themselves by their current gender identity and not as a trans male or trans female.

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Dr. Andrew Pinto, a clinician-scientist at Toronto’s St. Michael’s Hospital and one of the study’s co-authors, told Global News that researchers surveyed over 14,000 patients in health-care settings and asked them: “What is your gender?”

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Respondents were given the options female, male, trans — female to male, trans — male to female, intersex, other, prefer not to answer and do not know.

“When we compared people’s answers to medical information in their chart, we found this discrepancy,” Pinto said.

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The researchers found that many patients who had been classified as transgender or gender diverse in their medical chart “did not self-identify as transgender but rather selected female (23 per cent) or male (15 per cent).”

“Really, what that [finding] is saying is… that some individuals who are gender diverse and transgender actually do not want to say their gender is trans. If they are asked a question like: ‘What is your gender?’ They’ll choose their current gender identity.”

Pinto said that this finding is aligned with other research in this field and is an important lesson for health-care providers.

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“If [gender] is not correctly identified, it could be because the person has not felt comfortable disclosing it and that conveys something about the level of trust that they have with that clinic or that provider,” Pinto explained. “It could also be that it’s never been explored or asked by the provider, too.”
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Research shows that transgender people often face barriers to health care, including lower rates of cancer screenings, which can impact the quality of treatment they receive.

“Right now, the only kind of standard [in Ontario] is what’s on our OHIP card, which only has male, female and more recently, ‘X’,” Pinto said. “So it is up to individual organizations what they choose to ask.”

To better serve patients, Pinto said doctors should ask patients about their gender identity. The study also found that the majority of patients would welcome such questions.

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“One of our recommendations is that health organizations should actually ask a two-part question: ‘What was your sex assigned at birth, and what is your current gender identity?'” Pinto said.

By asking this two-part question, doctors may be better able to serve patients, as it’s important for providers to be aware of an individual’s medical history and unique needs.

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Furthermore, by asking more detailed questions around gender identity, Pinto said doctors are signalling a level of inclusiveness and respect for members of the LGBTQ community.

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“In Ontario, community health centres have been serving a very diverse population for many years, and many of them have embarked on asking these questions. But outside of community health centres, it’s very rare,” Pinto said. 

“Organizations need to be able to set the stage appropriately, which involves the appropriate training for staff and signalling to patients that their organization is an LGBTQ2S+ positive space.”

Laura.Hensley@globalnews.ca

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