Emergency: The Dire State of Transgender Healthcare
Late in July, Erin Vaught started coughing up blood. She did what anyone would have done and went straight to the ER. But Erin Vaught didn’t get treated just like anyone else when she went to Ball Memorial Hospital in Muncie, Indiana, because Erin Vaught is transgender. Instead, she was stared at and mocked in the waiting room, called a “he-she” and an “it.” Hospital staff entered her into the computer as male, despite the fact that her ID said “female.” When she went into the women’s restroom, everyone snickered.
Under these extremely adverse circumstances, she was kept waiting for two hours. She finally made it into the doctor’s office, only to be refused treatment because of her “condition.” When Erin, confused, said she didn’t know what her condition was, the doctor clarified: “No, the transvestite thing.”
In wake of media attention, Ball Memorial Hospital has promised to clean up their act. President Mike Haley has said in a statement that “the patient’s account of what transpired during her visit concerns us deeply and gave us pause.” The hospital has partnered with Indiana Equality and Indiana Transgender Rights Advocacy Alliance to create “a curriculum for employee LGBT awareness training” for Ball Memorial staff. While this may be a step in the right direction, many people, including me, remain incensed by the apparent lack of disciplinary action against the perpetrators of this outrage. Considering that Erin Vaught’s life was negligently endangered, I’d say that a lot more than sensitivity training is called for.
Erin Vaught’s case is hardly unique. Based on personal experience and the stories told by my friends, I feel comfortable stating that this sort of thing happens every day. Every transgender person ends up in a life-long struggle with the medical establishment which can often become a matter of life and death. Erin Vaught’s experience is only exceptional insofar as it got media attention, and the subsequent scrutiny got some actual results.
Another better-known case of extreme medical discrimination against a trans person was that of Robert Eads, who was diagnosed with ovarian cancer in 1996 and subsequently refused treatment by over two dozen doctors. This relentless prejudice on the part of the medical community lead directly to his death at age 53. His story is the subject of the documentary Southern Comfort.
Sadly, almost every trans person has a similar story, though some of them may be less extreme. I myself have been harassed by an ambulance tech, who persisted in asking me rude questions about my transition even while I was passing out and puking all over myself. I have been trailed by suspicious security guards through the ER, even though I was in no condition to cause trouble for anyone. Doctors and nurses have called me by outdated names and pronouns even after being repeatedly corrected. And I have to constantly educate health professionals about my body, my identity and my medical needs.
Considering the risks of seeking medical attention--being stared at and harassed in the waiting room, landing clueless or bigoted health practitioners, and even being denied healthcare--it can be tempting to avoid the doctor’s office all together. But trans people find themselves coughing up blood too. Worse, trans people have special needs which render us even more dependent on the medical establishment than average. Transition related needs, such as surgery and hormones, make it inevitable that many of us will be forced into lengthy interactions with the medical community. In light of this, the medical discrimination against us is all the crueler.
Take my case for an example: I’m a trans male who has been taking testosterone for almost two years and as yet have had no surgeries. I am dependent on the pharmaceutical industry for the hormone that makes me tick, and will be for my entire life. I am also a person who appears male by cis standards, but occasionally needs to visit the gynecologist. Last time I checked, my gender was entered into the Kaiser system as “O” for “Other,” which, while vaguely insulting, is at least better than female and lets the doctor know not to expect my body and needs to be those of a cis male. It’s still frighteningly imprecise, considering all the different types of bodies which exist beyond the traditional male/female binary which medical students learn about.
And there is so much to learn. Transgender health is a discipline all its own. It breaks down into two broad fields: transition related care, such as hormones and surgeries, and general care of non-standard bodies. You’d think this would be a fascinating topic that people would be excited to learn more about, really. Careers have already been made specializing in transgender surgery, and though trans people are a relatively small segment of the population, demand still far exceeds the current supply. One of these days, someone will catch on to this as-yet-unexploited market and make a fortune.
Erin Vaught’s case actually marks a step forward. The fact that Erin herself seems to be satisfied with the hospital’s response is very important, and quite unusual in a case like this. But I am not yet satisfied, and I can’t help feeling that Erin is being too forgiving. After all, this is about more than her. This is about the state of the world that we as trans people have to live in. Ball Memorial Hospital could set a strong precedent by dealing with this prejudice in a truly aggressive manner. Equal access to medical care is a matter of life and death, and needs to be treated as such. While sensitivity training could save lives, it is appropriate as a preventative measure, not as discipline. As far as I’m concerned, these bigots should be doing jail time, not attending a training to become more “tolerant.”
If Ball Memorial really cares about their patients, then they should fire the parties who mistreated Erin so egregiously. After all, her life was endangered. And going to the hospital should never be dangerous to one’s mental or physical health.