This year, University of Minnesota Health launched Comprehensive Gender Care, which provides coordinated care for transgender and gender non-binary people, no matter where they are in their transition. This clinical program is part of a wider gender care initiative within our health system that aims to improve healthcare for transgender and gender non-binary people.
Care Coordinator Ejay Jack, MSW, MPA, is often the first person prospective patients speak with when they contact University of Minnesota Health Comprehensive Gender Care. Jack helps each person navigate our services and find the care they need; he also serves as a vital link between our initiative and the larger community.
We caught up with Jack to discuss the new initiative, his day-to-day work and the future of transgender and gender non-binary care through University of Minnesota Health.
University of Minnesota Health Comprehensive Gender Care takes a seamless, integrated approach to gender-related care. All the transitional care options that someone may need, ranging from counseling to surgery, are available through the initiative. In addition, we are the only healthcare system in the metro area to offer gender affirmation surgeries for patients.
But the goals of our system-wide gender care initiative are also much broader. Part of the initiative’s work revolves around educating our frontline medical staff system-wide so that we can reduce the stigma and challenges that confront gender non-binary people as they navigate the healthcare system. This education is important because our society is so “pink and blue” when it comes to gender. We are also addressing this problem on a technological front. For example, we are updating our electronic medical record system so that it can better accommodate transgender and gender non-binary patients.
I am transgender, and I lived as gender queer for 10 years in high school and college. That experience really informs my current work as a social worker. I enrolled in the Peace Corps and worked in Gambia for two years. After that, I worked on HIV prevention and care programs for a decade, with a focus on healthcare disparities. This led me to the Presidential Advisory Council on HIV/AIDS (PACHA), which gave me an opportunity to talk about transgender people and HIV—interweaving my experiences in these fields. However, I’m a small sliver in the transgender umbrella of identities and expressions. I try to hold my own biases accountable, and I don’t speak for all transgender or gender non-binary people.
I serve as a liaison between our initiative and the transgender and gender non-binary community. I seek to understand the community’s needs, and then translate back to our institution. The reverse is also true: I work with our patients and prospective patients to educate them about our services, manage appointment scheduling, and navigate patient concerns or complaints.
As a care coordinator, I also work to reduce and eliminate the barriers that transgender and non-binary people face within the healthcare field. As someone who is both part of the community and a healthcare provider, I am familiar with many of the issues and see both sides. I also come from an advocacy and social justice perspective that is patient-centered. I use these experiences to help educate our own providers. For example, using someone’s preferred name rather than their birth name.
Our team recognizes that each transition is unique. Some patients may want surgery, for example, while others may only be seeking counseling or hormone therapy. There is no “wrong way” to enter University of Minnesota Health Comprehensive Gender Care. I meet prospective patients where they are at and help them navigate the various options. From the initial appointment onward, the whole process is focused on each person’s needs.
Provider education for our entire system—not just the Comprehensive Gender Care service—is also key to our work. We want our own staff to be educated to ask the right questions and not presume gender status or identity at the onset of a primary care visit. We want to create a compassionate atmosphere that enables our patients to discuss options and seek care freely, with as little concern as possible.
According to the 2015 U.S. Transgender Survey (USTS) issued by the National Center for Transgender Equality, 19 percent of transgender respondents were denied care, 28 percent were subjected to harassment in medical settings, and 2 percent were victims of violence in doctors’ offices.[DH1] The survey also showed that if medical providers were aware of the patient’s transgender status, there was a greater likelihood that person would experience discrimination. The survey had a sample size of 28,000 people. Half of those surveyed reported having to teach their medical providers about transgender care.
In our own system, we have had to deal with these issues. That University of Minnesota Health is willing to start a Comprehensive Gender Care initiative like this is a good first step. Our goal is to make seeking healthcare safer for transgender and gender non-binary people—and to better understand the experiences and perspectives of our patients. We want to ensure the community has access to the healthcare it needs, free from any stigma or discriminatory practices.