We Are All Different: Why Building Inclusive Healthcare for Transgender People Matters?

On April, at the Faculty of Medicine of Vilnius University (VU), transgender rights advocate and educator Ben Greene (USA) delivered a lecture entitled “Best Practices for Transgender Inclusive Healthcare”. In the lecture, he spoke about the most common societal fears related to transgender people and offered advice on how to create a safe environment for such individuals in a doctor’s office.

Do we feel comfortable in “our own chair”?

At the beginning of the lecture, B. Greene discussed concepts such as biological sex, gender dysphoria, gender euphoria, and related misconceptions. He stressed that reality is more complex than the conventional binary (two-sex) system: there is diversity in sex-related traits, genetics, reproductive systems, and people’s experiences and physical characteristics.

Using the analogy of a chair in which each of us sits, B. Greene explained gender identity: how comfortable we feel in “our own chair” – that is, in our body and biological sex – helps us understand how we perceive our identity. The lecture also addressed fears surrounding transgender issues that are prevalent in society. One such concern is anxiety about the diversity of identities: how can one keep track without becoming confused? B. Greene argued that, as with interacting with anyone, it is not necessary to share the same preferences or to be an expert with a deep understanding of every process; what matters is respecting the other person and accepting their identity as one would any other trait or characteristic.

The lecture briefly covered medical transition options, including puberty blockers, hormone therapy, and surgery, while also highlighting widespread misinformation regarding these interventions.

Research on the safety and experiences of the LGBTQ+ community in healthcare

The lecture presented research data showing that one of the greatest challenges faced by transgender individuals is the fear of visiting a doctor. Many of them report concerns about being treated inappropriately or not receiving proper care. Numerous individuals indicate encountering prejudice within the healthcare system, being asked inappropriate questions, and having their symptoms attributed to their identity or hormone therapy. As a result, patients may withhold important medical or personal information, avoid seeking healthcare altogether, or experience negative health outcomes such as substance use, depression, and addiction.

B. Greene also pointed to statistical data indicating a growing number of people identifying as LGBTQ+. Drawing an analogy with left-handedness, he noted that more people are likely to disclose their identity when they are no longer penalised for certain traits, as they feel safer.

Questions were raised about the boundaries of communication with transgender patients and what may be appropriate to ask during consultations. B. Greene advised avoiding questions unrelated to the patient’s condition or those driven purely by personal curiosity.

Lina Plieniūtė, Head of the NGO “Mothers for LGBTQ+ Children”, Assoc. Prof. Rūta Vosyliūtė, Head of the Department of Educational Competencies at the VU Faculty of Medicine and a member of the VU Equal Opportunities Coordinators Network, Ben Greene, transgender rights advocate and educator, and Rūta Trumpickienė, project manager of the NGO “Mothers for LGBTQ+ Children”. Photo from VU Faculty of Medicine archive.

A doctor you can trust

B. Greene encouraged the creation of welcoming, safe, and supportive environments within healthcare settings. This includes using patients’ preferred forms of address that align with their identity, expressing support, and handling sensitive information with care, especially when communicating with family members. He emphasised the importance of educating healthcare professionals. Situations in which doctors lack experience or knowledge regarding transgender healthcare can have serious consequences for patients’ well-being. Physicians should be familiar with these issues and able to formulate appropriate, care-related questions, such as: What do I need to know to carry out this procedure?

He also recommended avoiding generalisations about transgender patients and refraining from making assumptions, as individuals differ greatly in their needs and choices. Attention should be paid to terminology that makes patients feel comfortable and facilitates effective communication. It was suggested that healthcare providers should always begin by asking patients how they can help, rather than making assumptions.

Another important area, according to B. Greene, is ensuring access to resources – including information, literature, and support services – so that transgender patients can receive appropriate support. 

Research to identify challenges

During the discussion following the lecture, B. Greene answered questions from members of the VU Faculty of Medicine community and other participants about family attitudes towards transgender individuals and transition, as well as societal misinformation and fears. Participants inquired about the potential effects and legal regulation of puberty blockers, as well as the expected outcomes of hormone therapy. Questions were also raised about access to specialised healthcare services for transgender individuals. Attendees asked how doctors can communicate empathetically while also avoiding burnout. Topics such as detransition and other important issues relevant to both transgender individuals and society at large were also discussed.

According to Assoc. Prof. Rūta Vosyliūtė, Head of the Department of Educational Competencies at the VU Faculty of Medicine and a member of the VU Equal Opportunities Coordinators Network, patient rights in Lithuania are protected under Article 1 of the Law on Patient Rights and Compensation for Damage to Health of the Republic of Lithuania: “Under this law, patients’ rights may not be restricted based on gender, age, race, citizenship, nationality, language, origin, social status, belief, convictions, views, sexual orientation, genetic characteristics, disability, or on any other grounds, except in cases provided for by law, without violating the general principles of human rights. Therefore, healthcare professionals should be familiar with these requirements and adhere to respectful communication guidelines within their institutions.”

She also noted that research is being conducted in Lithuania to identify the challenges faced by LGBTQIA+ individuals and to assess healthcare professionals’ preparedness to provide care for these patients. One such example is a study carried out by the Institute of Hygiene on healthcare professionals’ knowledge, attitudes, and experiences in providing services to LGBTQIA+ individuals.

B. Greene’s lecture forms part of a thematic discussion series on transgender inclusion. This series is supported by the Baltic-American Dialogue program “Critical Conversation Series on Transgender Inclusion”, implemented by the NGO “Mothers for LGBTQ+ Children” with funding from the Baltic-American Freedom Foundation (BAFF). 

A recording of the lecture is available to watch here.