This is my second blog post in a series regarding transgender health and it is admittedly something that I knew very little about until I started doing my research. I was simply given the Rainbow Health Ontario website as a reference to find trans specific health resources. So I sat down and started going through the materials and was floored by the diversity in rad resources that were so readily available. My astonishment at the sheer volume made this a learning experience that required me to decenter myself prior to proceeding any further if the goal was to understand the challenges of those who are more marginalized than myself.
As a white queer cis woman who has a very feminine presentation, I am able to pass through space much like many other very feminine presenting white women do. The usual cat-calling and leering and feeling unsafe in (or avoiding) certain spaces are an obviously unpleasant aspect of the patriarchy for people who present like me. However, the microaggressions that I experience (as a person with much privilege) are insignificant in comparison to the challenges that many other people face.
Institutional settings present a unique set of challenges. If I am accessing health services, I may walk into a clinic and see a pride flag and feel that feeling of acceptance and safety. I will even see posters or resources that are reflective of some aspect of my lived experience (specifically my whiteness or being cisgender). Even if my sexuality is not reflected back to me, I embody the binary and an acceptable presentation of the social construction of a woman so I’m not likely to experience any barriers until it’s assumed that I’m straight and I have to out myself to the care provider. So what if I were trans or gender non-conforming? Would I feel safe if I saw the pride flag? This doesn’t necessarily rule out the risk of assumed or enforced gender binaries or the threat of healthcare professionals saying harmful things such as, “If you really want to start HRT, you may want to start dressing more like a woman.” (C. Farahbakhsh, personal communication, January 11, 2016)
I understand that it is important that practitioners consider the barriers that trans and gender non-conforming clients face when accessing healthcare and begin to take steps to ensure that they are represented within these spaces in the form of policy, practice standards, imagery and other resources (RHO, 2007). These acts of solidarity open up institutional medical spaces and welcome difference.
Perhaps most importantly, trans accessibility must be understood to be one of many components within a larger anti-oppression framework which also aims to center other vulnerable populations (RHO, 2007). This can include integrating policies and training workshops for staff that specifically center trans and gender non-conforming persons and the challenges they face with regards to discrimination and oppression (RHO, 2007). Similar to other inclusive policies that include through representation, mandates must deliberately present trans and gender non-conforming experiences in their marketing and outreach material (RHO, 2007). Additional policy recommendations can be found here .
Best practices could be developed and part of ongoing training programs for existing and new staff. Seeming quite obvious, these best practices are what centered clients would typically take for granted which would suggest just how marginalized trans and gender non-conforming persons are in medical spaces. These include respect, confidentiality, advocacy and collaboration with other healthcare professionals for continuity in (trans inclusive) care (RHO, 2007). (see link at end of previous paragraph re: policy recommendations for more information of best practices for trans accessibility)
You can post a transgender flag in addition to the pride flag.
Imagery beyond the flag is important insofar as it conveys a deeper sensitivity toward the barriers experienced by trans and gender non-conforming clients and there are many resources available. Ensure that there is a diverse representation of intersections such as race and ability. For example, Rainbow Health Ontario has posters available to order or download for free.
Gender neutral washrooms are incredibly important for trans and gender non-conforming persons. Click here for a guide in creating gender neutral washrooms (and policies including training of staff) as well as a list of signs for posting which are also available to download.
It is also recommended to have information resources that are available for people to take with them. Have a section of resources for queer clients and ensure that some of these are specifically for trans and gender non-conforming persons. Rainbow Health Ontario has an extensive selection of resources for queer and trans clients that cover a variety of health concerns and are also available to order or free for download.
This is by no means an exhaustive list of steps that can create more inclusive spaces clients however it is a fantastic start. Take a look through the Rainbow Health Ontario site. If your surprise as to how easy it is to access these materials is even a fraction of what mine was, I imagine you too will be wondering why more practitioners have not yet started the process of making their practices more accessible as an act of solidarity with queer, trans and gender non-conforming clients.
Rainbow Health Ontario (Oct. 30, 2007). Policy Recommendations and Best Practices for Agencies Working Towards Trans Accessibility. Retrieved from: http://www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2014/08/Trans%20Policy%20Recomendations.pdf