Better understanding of transgender and nonbinary biology benefits patients

Many people have their complaints about navigating the health care system. But if a person belongs to an underrepresented minority group, like those in the LGBT+ community, the problems that person faces can affect not only interactions, but access to health care. More and more individuals are identifying themselves as transgender, gender queer or nonbinary. Despite this, the health care system is often ill prepared to meet the needs of these individuals in a professional and appropriate manner.

In a recently published scholarly review of research gaps related to treatment of individuals who identify as gender nonbinary, Deborah Clegg, Ph.D., associate dean of research in the College of Nursing and Health Professions, found that enhancing the scientific understanding of biological origins of gender identity may reduce stigma and barriers to care for transgender and nonbinary individuals.

"There is an increasing number of individuals who self-identify as nonbinary when it comes to gender," said Clegg. "As this increasing population continues to grow, two items become salient: First, we need to appreciate the health care struggles many individuals find when they approach institutions who are not educated about how to approach and treat their needs. Second, we need to begin to conduct thoughtful research to understand the biological underpinnings of self-identity of gender nonbinary. It is through research and education that we can best learn to be appropriate, respectful and engage this growing population of individuals to care for their needs."

The perception that the medical community doesn't understand the unique challenges of nonbinary individuals leads to an inherit distrust of the health care system.

"My article begins to address these gaps in knowledge," said Clegg. "It highlights potential biological factors which may impact gender identity other than binary. It calls out to the health care community that we need to increase our understanding and knowledge of these individuals' specific needs. This is increasingly timely and important due to the ever-increasing prevalence of this population."

Clegg's scholarly review shows there is limited amount of scientific data on the biological origin of gender identity. She highlights the fact that one of the reasons there is not a sufficient amount of data on gender nonconforming people is that the biological definition of "gender" remains elusive. This is in part because molecular and biological techniques have not been available to accurately investigate the development of gender identity.

Reducing the social stigma associated with gender nonconforming individuals is one way to begin to break down barriers of distrust and enhance communication within and outside the medical community.

"It's meant to help the health care provider gain an understanding on transgender biology so that they are more respectful of transgender patients for whatever health care needs for which they may seek care," said Clegg. "Individuals who identify as a gender other than binary are being shunned by society resulting in increased suicidal ideology, bullying and large amounts of depression. If we are better able to understand why individuals might identify as nonbinary, we can begin to increase our acceptance of this growing population who is underserved."

The report, "A Universally Accepted Definition of Gender Will Positively Impact Societal Understanding, Acceptance, and Appropriateness of Healthcare" was recently published in Mayo Clinic Proceedings.