75% of US breast imaging facilities lack gender inclusivity training, transgender patient policies

Roughly 75 percent of breast imaging facilities in the U.S. do not have explicit policies for transgender patients and do not offer nondiscrimination training to appropriately care for lesbian, gay, bisexual and transgender (LGBT) patients, according to research published June 20 in the Journal of the American College of Radiology.  

Results from a national survey by the New York University Langone Medical Center demonstrated that most breast imaging facilities in the U.S. lack methods and tools to consistently use transgender patients' preferred names and pronouns. 

"All breast imaging facilities should recognize the ways in which their practices may intensify discrimination, exclusivity and stigma for transgender patients and should seek to improve their transgender health competencies and foster more inclusive environments," wrote lead author Julia Goldberg, PhD, a radiologist at NYU Langone, and colleagues. "Breast imaging facilities should ensure they have structures in place to provide respectful and quality care to transgender patients."

Goldberg and colleagues electronically sent their breast imaging facility policies and practices survey to roughly 2,500 breast radiologists in the U.S. in January. 

The researchers then collected results from 144 survey respondents, representing breast imaging facilities from 38.2 percent academic institutions, 5.6 private practices, 2.1 percent government or veteran's affairs and 54.2 percent "other" or "unsure.” 

Some 78.5 percent of breast imaging facilities that responded have gender-neutral patient bathrooms and 9 percent have a separate waiting area for transgender patients. Additionally, 76.4 percent do not have dominant pink hues in their facilities, although 54.2 percent have displays with female gender content, according to the researchers. 

Almost 75 percent of facilities reported they do not have explicit policies related to the care of transgender patients and did not offer mandatory nondiscrimination and LGBT health issues training for breast imagers to appropriately care for and communicate with LGBT patients and employees, the researchers wrote.  

The results also demonstrated that 58 percent of the facilities patient intake forms do not ask patients to state their gender identity. Concerning electronic health records, 33 percent of facilities said to have lacked a place to record a patient's preferred name and 55 percent did not have a place to record a patients' gender. 

"Such data collection on gender identity is critical to enhance respectful communication and provide each patient with appropriate care," Goldberg et al. wrote. "Implementing these systems not only would contribute to better patient care and demonstrate the facility’s commitment to improving LGBT health, but also would allow for more widespread research on the medical needs and health service utilization of the transgender population." 

The researchers suggested that breast imaging facilities can improve gender inclusivity by developing patient intake forms, radiology reports, patient letter and records within patients' electronic health systems that don't assume patient gender, as well as implementing appropriate training for radiologists and staff and developing comprehensive clinical guidelines to help standardize LGBT care and embrace transgender patients in a more inclusive clinical setting. 

"The clinic environment can serve as an initial demonstration of inclusivity," the researchers wrote. "Improving the facility environment can advance faculty and staff transgender health competence as well as improve patient outcomes, retention rates and regulatory compliance."