Transgender and Gender Nonconforming Patient Experiences at a Family Medicine Clinic.

Purpose: Transgender and gender nonconforming (TGNC) patients have a wide array of often negative experiences when accessing health care, and may encounter insensitive or subcompetent care; thus, the authors conducted a qualitative study with patients at one family medicine residency clinic to assess how primary care clinics can improve care for TGNC patients. Method: In 2015, the authors held three separate focus groups at Smiley's Family Medicine Clinic in Minneapolis, Minnesota. They invited diverse TGNC participants who have accessed TGNC-related and/or primary care at Smiley's. The authors analyzed and coded data using a grounded theory approach with NVivo10 (QSR). The authors also administered short demographic questionnaires and analyzed the results with REDCap.

Results: Twenty-three patients participated in the focus groups, and 22 completed the survey. Gender identities among the participants were diverse. Four main themes emerged: (1) shared negative experiences with health care, (2) the need for sensitive and inclusive primary care, (3) defining TGNC-sensitive care, and (4) the challenges of mainstreaming TGNC-competent care into primary care settings.

Conclusions: Providing sensitive and competent primary care to TGNC patients involves allowing patients to self-identify, respecting the gender identities of every patient, and focusing on the whole person-not the trans status of the patient. Education and training on TGNC care at a clinic-wide level is needed.