Transgender Patient Care at Breast Imaging Facilities

In a survey of US breast imaging facilities, researchers found that 73.4% of facilities lack explicit policies for the care of transgender patients and only 14.7% offer LGBT competency training.

The study, which is currently in press in the Journal of the American College of Radiology, utilized a national survey conducted by the New York University Langone Medical Center. The authors note that trans patients use radiological services throughout their lives, but they may require breast imaging in particular for both breast cancer screening and gender confirmation surgeries; because breast cancer is frequently portrayed as a “women’s cancer,” imaging facilities may have gendered environments that can cause trans patients to feel unwelcome or unsafe. In addition to assessing patient experience, the authors also investigated medical care, patient records, and facility policies.

The authors found that most of the facilities (54.2%) have signs, displays, and other graphics with female gender content on them, which may exclude trans patients. They also found that many intake forms do not ask patients to provide gender identity yet 25.9% of breast imaging facilities automatically populate their intake forms with female phrases. Many electronic health records do not provide space to record preferred name or pronouns, and the authors argue that this data collection is critical for future care and communication.

They also conclude that structural policies for trans patients and employees were overall weak. Only 14.7% of facilities offered LGBT training and only 33.3% of those trainings were mandatory. The authors present some suggested practices to promote an inclusive culture for trans patients at breast imaging facilities:

  • Clinic environment should not be exclusively gendered for women

  • LGBT training should be a part of each employee’s on-boarding process

  • Facilities can develop LGBT nondiscrimination policies for both patients and clinic employees

  • Gender-neutral bathrooms should be available to all patients

  • Patient data (including intake forms, electronic health records, radiology reports, and patient letters) should include chosen name and pronouns, gender identity, and the sex listed on patient’s original birth certificate

You can access the full text in the Journal of the American College of Radiology here: https://www.jacr.org/article/S1546-1440(18)30599-4/abstract

You can learn more about the LGBTQ competency training services offered by QSPACES here: https://www.qspaces.org/lgbtq-training/