​Healthcare organizations need to do a better job identifying their providers who offer care for transgender patients, said Jarrett Sell, MD, AAHIVS, medical director of Alder Health Services, Harrisburg, PA, at the fall conference of the Pennsylvania Association for Health Care Risk Management in Hershey (September 15, 2018). "We need ways for individuals to find providers," said Sell, who described transgender-specific health services, such as those provided at Alder Health. "I now say that I provide hormone therapy," which is used to either feminize or masculinize the body, said Sell. "We can improve identifying these providers who will treat [transgender] patients," he said. "It's traditionally been challenging for [transgender] patients to find a doctor who can provide care." Other strategies to make the healthcare environment gender affirming for transgender clients, Sell said, include asking patients about their preferred pronoun or preferred name to avoid mistaken assumptions about the patient's gender; using forms that are inclusive for transgender patients; designing the electronic health record to clearly identify preferred names and pronouns; educating staff on all-inclusive care; designing welcome packets that provide information relevant to the transgender community; and becoming educated about the needs of lesbian, gay, bisexual, and transgender patients. "When I graduated from medical school in 2000, I didn't hear lectures on this. Even if it's in the curriculum today, it's a small part," Sell observed.

HRC Recommends: Healthcare organizations and individual providers should commit to providing patient-centered care. Patient-centered care involves respect for the patient's values, preferences, and expressed needs; provision of health information and education; timely access to care; provision of emotional support to relieve fear and anxiety; involvement of family and friends; continuity of care and safe, smooth transitions between healthcare settings; physical comfort; and coordination of care. Risk managers may wish to take an inventory of the organization's existing policies and procedures and ensure that they incorporate patient centeredness and specifically address patients' gender identity. They should also assess how the organization operationalizes patient centeredness for transgender patients and visitors.