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PHILADELPHIA—When Barbara Mclean walked into the doctor’s office, she expected care. Instead, the 52-year-old transsexual experienced nothing but hostility during her physical examination. “The doctor thought I was one thing, but I was another,” says Mclean. “At first when I got there, they asked the normal questions you would expect at a doctor’s visit, but when I lifted up my robe, their whole attitude changed.”
 
A new study from Public Health Management Corporation (PHMC) shows Mclean’s experience is not atypical within Philadelphia’s transgender community. According to a survey conducted by PHMC research associate Lee Carson, of 127 transgender participants surveyed almost one in five report unequal treatment or service within a doctor’s office or hospital and 14% report verbal harassment or disrespect while there.
 
“For the first time in about a dozen years, we have an assessment of the needs of transgender and gender variant individuals in Philadelphia,” says Gloria Casarez, director of the Mayor’s Office of LGBT Affairs. “It shows us that there is still a lot of work to be done throughout various sectors. The report affirms the need for inclusive policies, the need for additional data collection, and highlights key areas of concern for this population of people.” Like Casarez, Carson and fellow researchers hope the report will expose disparities in transgender health care access and encourage health care providers to treat transgender clients with sensitivity and support.
 
In collaboration with Transgender Health Working Group, Carson surveyed transgender participants at various community organizations about their experiences with medical health conditions, mental health conditions, health discrimination and health providers, as well as discrimination with law enforcement* and obtaining employment. “This study is important because we don't have nearly enough data on the health, wellness and life context of transgender and gender non-conforming Philadelphians,” says Carson. The study, funded by Pennsylvania Department of Health, hopes to fill some of those gaps.
 
According to the study’s results, close to 30% of the participants were uninsured 56% stated that they faced depression and a high number reported substance abuse problems. However, getting care for behavioral issues has proved difficult for a transgender person. The study showed that 17% of participants reported harassment in a mental or behavioral health program.
 
“A lot of our women talk about facing challenges in getting help for their drug and alcohol problem,” says Tonya Middleton, case manager at PHMC’s New Pathways for Women, a program that helps women transition into recovery and where Mclean receives care. “Some report having gone to facilities that are all women and being looked at a certain way. Others recall how they would go to a doctor’s office and the care provider would still call them by a male name.”
 
As November 18th marks the 11th annual Transgender Day of Remembrance, a day to memorialize those in the transgender community who died due to transgender hatred or prejudice, advocates in Philadelphia hope to raise awareness of health care discrimination. Says Carson, “In this day and time of restricted funding resources, data drives funding, so the only way we can increase resources for this population is to gather data.”
 
*Information available upon request.

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