Some years ago I hit my head on a concrete floor while experiencing a seizure. I regained consciousness in an ambulance and I remember a huge throbbing pain in my head. But when I complained about this pain it was dismissed as, “probably a slight headache”, with no further examination as if I was exaggerating the pain.
Luckily for me it turned out to only be a minor concussion but had it been more serious, I could have suffered a much more negative outcome. Truthfully, I have had quite a few instances that look like this scenario, and this is the reality for many transgender black people and people of colour (BPOC) who are at increased risk of being overlooked or dismissed when it comes to expressing symptoms like pain.
There are many instances where pain can present itself in non-physical ways, and it’s up to the healthcare provider to use their discretion to treat patients. It can be a scary thing to experience being at someone else’s mercy to this extent, especially as BPOC who are transgender face additional challenges in accessing healthcare due to both our race and gender identity. We go to healthcare providers as we trust them to have our best interest at heart and know the correct treatment, but this can open up the opportunity to experience discrimination and bias when seeking healthcare due to both of these characteristics.
This isn’t just limited to expressing pain. Usually pain is a symptom of a larger problem at hand, for example BPOC trans people have some of the highest rates of depression reported at around 67-70% in a 2017, anxiety and other non-physical ilnesses that may sometimes include pain-like symptoms. This can be an overwhelming experience, made worse by the fact that many healthcare providers struggle to understand the specific needs of BPOC trans patients, such as access to sensitive care. This becomes evident in the experiences of the community, as 62% of trans people have experienced a lack of understanding of specific trans health needs by healthcare staff in a Stonewall report¹. A huge contributing factor to this lack of understanding is a lack of training to enable healthcare professionals to provide this sensitive care for BPOC trans people and lax guidelines for using discretion to provide care.
Unfortunately, due to conscious or unconscious bias, there is a lack of understanding of trans BPOC patients and their experiences by the healthcare system². A survey by TransActual found that 53% of BPOC reported experiencing racism while accessing trans-specific healthcare services, and 69% of that number reported being impacted by racism from non-trans-specific healthcare providers³. This mistreatment has the unfortunate effect of making myself, and many other BPOC trans people alike, fearful of seeking care. This mistrust in the healthcare system can be dangerous as it can lead to patients delaying important appointments and avoiding treatment. In the case of a close BPOC trans friend of mine this looked like going several months untreated for depression which had severe consequences for their health and well-being.
Moving forward it’s really important we embrace a new outlook on seeking healthcare as trans BPOC individuals. We should never be afraid to seek a second opinion for a diagnosis or to push for further action to be taken i.e. examinations that may just save your life. However, in order for us to do this, it is important for healthcare providers to be aware of these issues and work to address them, as a lack of sensitivity can result in BPOC trans patients experiencing discrimination when seeking care, as well as a reduction in the quality of care provided to BPOC trans patients.
Providing better care to BPOC trans patients, eliminating bias and discrimination within the healthcare system is really important for the community. This can involve implementing culturally competent care and addressing disparities in access to care. In doing this, the healthcare system does the work to understand the intersectional experiences of trans BPOC people, and eliminate racial and transphobic discrimination to improve the perception of non-trans and trans-related healthcare for BPOC individuals. In this way, we can one again feel safe asking for help in these spaces.
- Stonewall report 2018: LGBT in Britain – Health Report
- Hoffman, Kelly M., et al. “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.” Proceedings of the National Academy of Sciences 113.16 (2016): 4296-4301.
- TransActual Trans lives survey 2021: Enduring the UK’s hostile environment
This article was funded by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.