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WVU Medicine improving care for transgender patients through training, departmental curriculum, improved medical records, and more
MORGANTOWN, W.Va. – Across the nation, many individuals who identify as transgender or gender diverse avoid accessing health care, even basic primary care, because of fear of discrimination or mistreatment — but WVU Medicine is implementing a number of strategies to improve care for this patient population.
“The overall goal of this program is to make WVU Medicine and all our hospitals and rural clinics and providers to be gender-affirming in their care, which means providing sensitive, thoughtful care to transgender and gender diverse West Virginians,” Molly Fechter-Leggett, Psy.D., special projects director for transgender health at WVU Medicine, said.
Research shows few medical schools across the country offer LGBTQ+ training, and even fewer offer transgender specific training. But at the WVU School of Medicine, at least two departments — Family Medicine and Pediatrics — are incorporating transgender care into their curriculum by including standardized patients who are transgender. For some medical students, this training will provide an initial comfort with the topic area, but for others, it may lay the foundation for a specialty focus in gender-affirming care.
Additionally, through training called “Advancing Excellence in Gender Affirming Care,” students, existing providers, staff, and others can learn the ways in which patients are being discriminated against and learn how to treat them the way they want to be treated, such as using their preferred names and pronouns. Providers can also learn how to have sensitive conversations with their patients to provide the care they need.
“It’s OK to be new at this,” Dr. Fechter-Leggett said. As a licensed clinical psychologist, she said she received no training on this patient population during her graduate education. “When we learn, we’re going to make mistakes. The important thing is that providers and staff at WVU want to do good work. They’re coming at this with open hearts. There may be discomfort or a lack of understanding, but they see the value in hearing the experiences of trans people.”
WVU Medicine is also working to improve the patient experience by updating the way patient data can be recorded — as system changes are implemented, patients in the WVU Medicine system will be able to self-identify with their preferred name and gender, even if it doesn’t match their insurance information or identification cards.
“Some trans people don’t want to seek medical care because their ID is in a previous name, or they don’t want to be misgendered by someone,” Fechter-Leggett said. “It’s a constant microaggression of people not seeing you for who you are. This is a huge project that will impact the lives of those who access our medical system.”
According to a Williams Institute study from 2017, West Virginia has the highest percentage of 13- to 17-year-olds who would identify as transgender (roughly 1,150 in-state youth), making care for this patient population all the more important in the Mountain State.
“We have the opportunity to lead the nation in this type of care,” Fechter-Leggett said. “Having a provider who is knowledgeable and affirming of gender identity allows a patient who is likely on guard to feel comfortable and confident that their provider understands the context of their experience and their concerns. Knowing you’re safe, seen, and heard, and that your medical care will be provided in the best way possible — isn’t that what we all want?”
The gender-affirming care initiative began in 2019 when WVU Medicine leaders, medical providers, and human resources staff came together to discuss healthcare barriers that transgender and gender diverse people experience. Since then, Fechter-Leggett said more than 500 individuals across WVU Medicine and WVU Health Sciences have received some form of gender affirming training.
Not only does the WVU Health System want to improve patient care, but to become a better supporter of its transgender and gender diverse employees. Fechter-Leggett has been working with Human Resources to develop a “transitioning on the job” policy to help guide employees and managers through questions that may arise, to make the transition for all parties as smooth as possible.