Table 2 Major Findings from the Qualitative Data Analysis: Themes, Subthemes, and Illustrative Quotes

The Power to Help or Harm

Health care providers

117 (32)

“This mom said they had a wonderful experience with their pediatrician, who “never missed a beat” and just allowed [Taylor] to be [Taylor]. While she expressed gratitude about her family’s experience, she did share that [a nearby hospital] will not care for transgender children. This was incredibly disheartening to hear. This highlights the many existing opportunities within healthcare for providers to advocate for their patients and become better allies to the LGBTQ+ community.”

“Medicine is a field about human interaction where the type of care we provide and the trust we have with our patients are always fluctuating. I think it is our responsibility to meet our patients where they are and work with our patients to provide the care that everyone deserves. Hopefully by interacting with different people and learning about the stories of others, we will be able to more strongly empathize with the struggles that the patients are going through. That way we do not add to the problem, but can be support that these families can lean on.”

Family

65 (18)

“One of the TransParent-ing members shared her own experiences transitioning as an adult and how she wished she’d had support from her family at a young age because she was in her fifties by the time she felt that she could be authentically herself. While this was heartbreaking, it was so informative about the emotional toll of not feeling supported by family members.”

“I think there is a misconception that parents have to do extravagant things in order to provide support and a comfortable environment for kids to express themselves. While this may be important to some, his mom’s acknowledgment of his gender and openness to expression gave him the space to be authentically himself. She addressed this when she said “I didn’t parent any of my kids differently”. Creating an open and welcoming environment just requires unconditional love and open communication.”

Faith communities

25 (7)

“Faith communities can benefit the health outcomes of transgender patients by establishing an atmosphere of compassion rather than condemnation so as to avoid traumatizing and hurting these individuals. Something I wish faith communities realized is that unconditional love does not mean unconditional acceptance; you don’t have to agree with how someone lives their life in order to love them. Love is action and if more individuals accepted this, it could have a huge impact and improve the quality of life, and thus overall health, of transgender patients that live in a society where they must constantly worry about harassment, rejection, etc.”

“If transgender patients feel they are being persecuted and discriminated against, they will naturally tend to have more anxiety and potentially worse mental health outcomes. On the contrary, faith communities, if they are supportive and caring, can be a great safety net and support system for transgender patients.”

The Responsibility to Provide Health Care

Responsibility to be educated

63 (17)

“It did seem like most of the problems that the panel members faced were because of lack of knowledge about the transgender community. Lack of knowledge is not an excuse to give someone a bad experience in healthcare. Medical professionals should be able to treat any person while also recognizing the intersectionality of the people they see.”

“I think the most impactful thing I heard was when one of the panel members was repeating stories she heard of people going in for the healthcare appointments where the physicians did not really know or understand their anatomy (ie. not knowing the patient did not have a uterus). It really emphasized how important it is that we be educated on different procedures and hormone therapies that are involved in transitioning because it would be dangerous to treat transgender patients by just making guesses or assumptions”

Responsibility to build trust

21 (6)

“We have to remember that we may be healthcare professionals, but this is still a partnership and we don’t know more about a person than they do, so in order for us to give them proper information to make decisions about their care, we have to ensure that they feel as if they can even trust us enough to be open about sensitive topics.”

“Using the correct language when caring for transgender patients and clients is affirming to them and helps create a trusting relationship between the provider and patient. This relationship of trust is important in the health care setting because it means more information is probably shared with the provider, which leads to more accurate diagnosis and treatment.”

Responsibility to create a safe space

50 (14)

“The panel members mention how the doctor’s office is a place where they feel uncomfortable and nervous, so whatever I can do to give them a safe environment will be put in place… It is important that members of the transgender community feel comfortable and safe within a hospital/ therapy setting, as it may be the first time.”

“I hope that as physicians, and just people in the community, we are able to cultivate a supportive and welcoming space that doesn’t require transgender youth to have to prepare themselves for the outside world by growing that thicker skin.”

Navigating professional and personal identities

46 (13)

“Even though we are not required to provide gender affirming care, especially if it is contrary to religious beliefs, it is important to be able to understand patients perspectives to refer them to where they can go. Many of these patients experiencing gender dysphoria are undergoing internal conflict, and it is important to refer them to the resources they want if we are unable to or are morally prevented from providing them ourselves.”

“Everybody is entitled to their opinion and point of view, and no one is called to affirm or support a view especially if it may require us giving up our own…Judgement is never ours to give, but faith informs many of us of the humanity in each other. Recognizing this humanity is easy and universal, and is a way to support these communities.”

“I think this breakout session gave me a lot to think about as an individual who grew up in the Catholic Church and attended Catholic schools throughout my life. One individual during this breakout session asked a question regarding the future for the Catholic Church and if BLINDED FOR PEER REVIEW believes there will be any changes made to support those who are transgender and non-conforming. BLINDED FOR PEER REVIEW believed it is important to start conversations surrounding this topic and the Catholic Church. I think one way we can start this change is through discussion with family members and other members in the Catholic Church. One way I think we can do this is by loving and accepting everyone and their differences. As healthcare providers, we can start these conversations with other healthcare professionals and be allies for those within the community.”

A Posture of Humility: Listen and Learn

Centering transgender narratives

127 (35)

“Learning of the different medical experiences of transgender people was surprising to me. I expected to hear some of that information, but hearing it still surprised me nonetheless. It’s heartbreaking to know that gender diverse people can’t be treated with respect, but it’s also sad that general information about the community is lacking within medical professionals.”

“Hearing the panel members discuss how they have been discriminated against in the health field was a very eye opening topic for me as well. I liked how you mentioned that these situations don’t happen for people who aren’t transgender, so they shouldn’t happen for those who are. I think this is an important topic to bring to light because everyone should be treated equally, regardless of how you identify. Transgender individuals should not have to feel uncomfortable or nervous in any environment, especially the doctor’s office. To hear about the disrespect they have been shown in a place where they should feel the most safe pushes me even further to want to create an environment that is inviting and accepting of all people.”

Openness to continuous learning

27 (7)

“I think it’s great to acknowledge the limits of our knowledge and to be open to learning more so that we can help our future patients. It’s humbling to realize that there are lots of considerations for our future patients that we may not have ever thought about or even realized had to be considered.”

“As clinicians, we have an ethical responsibility to provide culturally competent care, which requires an understanding of the array of identities and expressions that transgender and gender-nonconforming people represent. Once we understand what culturally competent transgender care looks like, we must continue to educate ourselves, actively listen to community members, and recognize and address our personal biases.”

Practical takeaways

73 (20)

“I also realized during the panel how much practice it can take when you are not used to using this language. As future physicians, using inclusive language is key to establishing a productive healthcare provider and patient alliance. We want to respect the patients by using inclusive language so that they can focus on their health, rather than whether their provider will discriminate against them.”

“‘Practice makes progress, not perfection’ is one line that stuck with me today. As healthcare professionals there is always room to better your treatment and self to be inclusive to everyone.”