November is recognized as Transgender Health Awareness Month. This is a time to reflect on the experiences of transgender and gender nonconforming individuals seeking and receiving health care. It is also an important reminder of how everyone can take action to create a more equitable health care experience for all.
Alexis Dinno, is an associate professor at the Oregon Health and Sciences University, at Portland State University School of Public Health. I teach methodology courses, courses on introductory epidemiology, social health methods and theory, and biostatistics courses. She also teaches courses about health equity and justice focused.
Watch the full interview or read a transcript of the conversation below.
What is your name, pronouns, your relationship with the bleeding disorders community, and LGBTQIA+ community?
I'm Alexis Dinno, an associate professor at the Oregon Health and Sciences University, at Portland State University School of Public Health. I teach methodology courses, courses on introductory epidemiology, social health methods and theory, and biostatistics courses. Likewise, I also teach courses about health equity and justice focused.
Why is it important to highlight health care for the trans community specifically?
I am transgender myself, I am queer, using a variety of labels, and I think about how things like demographic questions, whether it's on a survey or whether it is paperwork someone is filling out when they come to a front desk, and how that does so many things. This affects the nature of a relationship between a person on one side of the counter and the other.
It affects the relationship between a patient and a provider. It also affects the quality of our science.
We all have needs. Transgender people have a need for respect and dignity around things like pronoun use and around things like name use because pronouns and names are institutionalized and colonized in terms of what counts as a name and what counts as a gender.
Folks who don't fit this sort of hegemonic, the broader societal narrative are more vulnerable.
Has being transgender affected your experiences with health care providers?
There is uncertainty about whether a clinic will be friendly or not. My last two providers I have adored, and they both retired on me recently, and I haven't gone in to see my new provider because this provider was pre-assigned to me. I didn't get the opportunity to say, hey, I'd like to find a queer provider or a provider who specializes in transgender care.
And so, I'm feeling a little reticent.
The question of access is very important, and at 53 years old, I'm an advocate. I know about trans health serving the professional community because I meet with them routinely, and I can have this kind of inhibition around access.
What do you wish more health care providers took into consideration when caring for transgender patients?
There's a philosophy, called cultural humility, and it's emerged, and in some ways is a response to notions of cultural competence. Cultural humility only recognizes that the relationship is part of a co-learning relationship, co-teaching, co-learning, and collaborative. The question is that the providers come with some humility to say, who is this person?
And again, centering the person there in their care. I think that the collaboration and education space should be for that. That's also part of the cultural humility frame that some providers profess and try to work with.
Given the current political climate, how would you recommend people advocate and show support for the community?
The political climate is that some states have an interest in politically punishing Queer people and bodies and really institutionalizing that punishment in law, and this terrifies transgender and queer people; and terrifies their families.
We can show our support by organizing politically to ridden anti-public health laws and work on that inclusion. If you're running a clinic, you can train your staff and yourself to welcome folks with consciousness of names and pronouns and ask people what is happening with their bodies.
To make these efforts and when you ask these kinds of questions to young people and their parents, I can tell you that parents who have gender-nonconforming children are so glad when they see the opportunity to say I want to talk about this.
What would you like to see in the future for the community?
I think the issue about welcome and inclusion applies no matter the specialty or the general practice of any provider. But also recognizing where things like sex intersect and reproductive biology intersects with, um, uh, bleeding disorders in ways that are interesting, right? Um, and, and affect things, uh, you know, the way, way, uh, health and disease play out.
There's a real possibility for gain. By recognizing that we can ask questions about people's bodies and about their physio, you know, their anatomy and their physiology in a way that will lead to the best, best quality of care for them.
