Speaking with your provider
It can be challenging to speak to a care provider about gender-affirming or trans health care. You may not know how to bring it up or you may be concerned about their response. Here are a few tips to help start these conversations.
Book an appointment
The first step in speaking with your care provider is to book an appointment. While this might seem simple, sometimes feeling anxious can make this difficult. If you find booking an appointment hard, consider asking someone for support. A friend or family member can be with you while you call or book an appointment on your behalf.
Most appointments are 10–15 minutes long and there is usually only time to discuss one health topic per visit. At the first visit, you can share your goals with your provider and make a plan together to address them. You can also discuss whether booking a series of appointments in advance would be helpful.
Be prepared
Think of goals or concerns you would like to speak about. Make a list and then organize it from the most to the least important. Bring this list to your appointment — you can give it to your provider to help start the conversation.
Here are some questions to help you identify topics you might like to discuss:
- What care do I need? For example, hormone therapy, surgery, trying medication, options for caring for my mental health, etc.
- What kind of support am I looking for? For example, getting more information, providing referrals, updating my name and/or pronouns, helping me move forward with hormones or surgery, etc.
- Is there anything about my gender and how it relates to my health that I want to share? For example, you may want to share with your providers the words you use to describe your gender and your body.
Anticipate a bit of waiting
Not all clinicians have learned how to provide gender-affirming care Processes through which a health care system cares for and supports an individual while recognizing and acknowledging their gender and expression. . They may need to consult colleagues or resources before they can start treating you. Some may not feel ready or confident to provide certain aspects of care and may refer you to providers with more experience.
If your provider is willing to help, but they are not sure how or where to start, you can suggest the following:
- They can begin with the Health Professionals information on our website
- They can speak with an an experienced clinician by calling the RACE line
- If they require further assistance, they can contact Trans Care BC for information, resources or practice support
Your care pathway may take longer than you hope or it may not be what you expect. Counselling and peer support may be helpful while you wait.
Follow up
It is common to need more than one appointment to address a single health care goal or concern. Book and attend follow up appointments so you can continue the conversation, review lab results or consult reports, and keep your care moving forward.
Know your rights
You have a right to be treated with dignity and respect by your care providers. This includes having the right to be acknowledged by your correct name, pronoun and gender.
For information about your rights in health care, tips on how to communicate your needs and requests, and pathways to file complaints, check out Trans Rights BC.
Navigating hospital and doctor’s office settings
You may access health care settings for many reasons, which range from a routine check-up to getting emergency care.
Though all health care settings should be supportive of transgender, non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. and Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) people, there may be moments you need to advocate for yourself.
Check-in and admissions
When you first arrive at a health care setting the first thing you will need to do is check-in. At check-in you will usually be asked for:
- Your CareCard (or another health care card applicable to you)
- The reason for your visit
Your name and pronouns
If your Care Card does not display the name that you go by or the gender with which you identify you can:
- Tell the person checking you in that the name you use is different from what is on your Care Card. Ask the person checking you in to record the name you use so that:
- Hospital staff will use only that name
- They will use that name to call you in from the waiting room
- Tell the person checking you in the pronouns you use, if you wish, and ask that hospital staff be made aware when providing care for you
Your right to privacy
Information about the purpose of your visit or the name/pronouns you use may not be things you want to discuss out loud in a busy waiting room. To protect your confidentiality you can:
- Ask for a private space to discuss your needs
- Ask for a piece of paper to write down personal information instead of speaking out loud
If the health care setting uses electronic charting, you can ask that your file be kept confidential (it may also be called a “VIP” setting). This request adds a safety barrier and may hide some information (such as your name on certain screens) or control who has access to your chart. Every system is a bit different so the screen settings or appearance will vary between health care settings.
- An example of how to make this request to admitting personnel or your nurse is to say, “I would like my chart to be confidential, please” or, “Can you change the settings to make my chart confidential?”
Meeting with health care providers
Throughout your time in a health care setting you may only meet with one provider or several providers. Each new provider you meet will check-in to confirm your identity and your reason(s) for seeking care.
Providers need to use two unique and acceptable patient identifiers Information used to distinguish one patient from another, such as name, date of birth, personal health number or other unique identifiers assigned by health care providers. These identifiers help ensure accurate identification and tracking of patient information in medical records and health care systems. according to their organizational policies. These identifiers allow them to confirm your identity.
What can you use as a patient identifier?
There are many identifiers that can be used that do not include the name on your medical chart/hospital wristband. You can request that the provider use your date of birth, Personal Health Number (PHN), Medical Record Number (MRN), Encounter or the Account Number associated with your medical chart.
- You can find the numbers mentioned above on your hospital wristband and can read them back to your provider who will confirm with your chart.
- If you do not have a PHN, or if you have other numbers in addition to your PHN, you may see them on your wristband, such as a Certificate of Indian Status number or Interim Federal Health Program (IFHP Interim Federal Health Program. This is a limited and temporary health care plan that provides health care coverage to some groups of foreign nationals who are vulnerable, disadvantaged or ineligible for provincial or territorial health insurance. ) Unique Client Identifier (UCI) number.
Telling health care providers your name
When asked your name, the provider needs to know the name you go by and may also request the name that is on your medical chart/hospital wristband to avoid confusion. An example of how to respond to this question is:
“The name I go by is ______. I have a different name that I do not go by on my medical chart. We can confirm using another identifier on my wristband.”
It may also be helpful to state your surname if that is the same on your ID.
Do you need to tell care providers your immigration status?
Hospital or health care setting staff should not ask you about your immigration status. If they do, you do not have to answer this question.
Discussing your care
Depending on the health care you seek, your health care provider may or may not need to ask questions about:
- Hormone therapy
- Your surgical history
- Your body parts
Ask for more information
Health care providers should only ask questions that are important to your care. If you are unsure of why you are being asked a question or why a certain exam is being recommended you can ask your health care provider to explain how that information applies to your care. If you are not satisfied with their explanation you can:
- Ask for further clarification; or
- Decline to answer the question or proceed with the exam.
Contact our team of experienced health navigators for information about gender-affirming care in B.C.