Though there does exist some research on healthcare for gender-diverse populations, it is disproportionately focused on transgender men and women and not on genderqueer or nonbinary (GQ/NB) individuals.

A recent study published in LGBT Health explores the healthcare experiences of young adults with gender identities outside of the standard gender binary. The authors found themes among the subjects’ described experiences, including providers’ inability to see beyond the transgender binary and lack of cultural competence in providing GQ/NB care. Subjects reported that providers were unable or unwilling to meet their specific GQ/NB health needs, such as varying levels of hormone therapy and gender-affirming surgery. Some used binary transgender language in interactions with healthcare professions in an attempt to obtain the care they needed because, as one subject said, “they’re not gonna understand genderqueer, but they’re gonna understand trans.”

It is important to note the clinical significance of these findings. One GQ/NB patient noted that they alter the dose of masculinizing hormones that they receive from their provider because they don’t want the full effects; this kind of medical decision making without assistance from professionals has the potential to be dangerous for GQ/NB patients. Other subjects report avoiding the doctor entirely, which can have obvious negative impacts on their health. The article reports findings from the 2011 National Transgender Discrimination Survey that GQ/NB individuals face even higher rates of discrimination in healthcare settings than their binary transgender peers.

The authors conclude that it is critical that providers receive cultural competency training to help their GQ/NB patients. They also encourage providers to take several simple steps to make these patients feel more comfortable:

• avoid assumptions

• ask open-ended questions

• listen and learn from GQ/NB patients

• encourage patients to relate their unique experiences of identity and health

• engage in the ongoing process of maintaining cultural humility and improving competence and patient satisfaction

You can access the full text of the study in LGBT Health here: https://www.liebertpub.com/doi/abs/10.1089/lgbt.2017.0215

You can learn more about the LGBTQ competency training services offered by QSPACES here: https://www.qspaces.org/lgbtq-training/