The Paper Chase
Tips for better treatment of transgendered patients at fertility clinics
You may have come across an article recently about a transgendered man feeling mistreated at a fertility clinic. He reported being called “she” and feeling degraded for a multitude of reasons.
Although no one can undo the humiliation that this individual felt, as a health lawyer who regularly works with both fertility clinics and patients I thought I would make suggestions that could help others avoid this kind of unfortunate circumstance.
- HAVE THE FERTILITY TALK
In the past I have suggested that people fighting cancer “have the fertility talk” with their doctors to ensure that fertility preservation happens early on (and not assume the doctor will bring it up). I make the same suggestion to anyone considering starting hormones. It may no longer be possible – physically or emotionally – to take the steps to preserve sperm or eggs after hormone treatments have begun.
This man discussed how going off hormones made him emotional and affected his appearance and confidence. It is difficult to imagine the stress associated with going off hormones, but I suspect in most cases it would be best to have the fertility talk and undergo fertility preservation procedures before transitioning.
- WRITE A LETTER
Any fertility clinic I have dealt with truly does want to serve patients well and to be inclusive. But as many people discover, going through training does not always result in proper service, and there may be some staff who don’t seem to absorb the message.
To a transgendered person undergoing fertility treatments, I would suggest writing a letter to the people who will be taking care of you and explaining your expectations and how you want to be treated. This includes not only health professionals, but legal and surrogacy professionals as well. Invite questions and be specific. For example, in this case the patient felt uncomfortable sitting in a hospital gown in a waiting room filled with female patients. Perhaps a letter requesting a private waiting room could help someone else avoid the same negative experience in the future. While I don’t want to suggest that all of the responsibility be on the patient, the reality is that client-initiated requests will likely (hopefully!) be respected and result in better service. As well, not every transgendered person will necessarily want the same accommodations – perhaps someone else would feel more isolated being made to wait alone and miss out on the social aspects of the waiting room.
And health professionals should not be shy about initiating this discussion either. Open dialogue can help to serve everyone’s interests.
- BRING A SUPPORT PERSON
In this particular situation, the man – who is highly educated, speaks English and is employed in the health sector – felt vulnerable. No one is immune from feeling powerless.
Fortunately he was accompanied by his wife who was able to serve as an advocate. Having a support person can reduce feelings of isolation and empower patients to speak up if they feel uncomfortable. When we are in the role of the patient any of us can feel weak, tired, exposed, embarrassed or subject to reprisal. A partner, friend or relative can advocate, distract and encourage.
- CONSIDER YOUR GOALS BEFORE TAKING ACTION
If you are not treated properly, think about what it is that you want done. Do you want an apology? Do you want your story to be validated? Do you want to ensure no one will be treated that way again? Do you want money? Do you want to see someone punished? Do you want to go back in time and re-write history? (the last one is a bit tricky!)
I ask many of my clients who feel mistreated by someone in the health care system the same question – what is your goal? Many people are able to articulate their frustrations, but have not yet considered what they hope to achieve. The goal directs the course of action.
Once we discuss the matter, I learn that people who feel wronged often want accountability and to see systemic change. In those cases we brainstorm what changes they want to see and how we can make it happen.
I would encourage health care providers in general to be open to those discussions, and not to react defensively and assume you are going to be sued or subject to a human rights complaint. I find that most people don’t want to litigate; they want to be heard and to make a difference to others.
About the Author
Lisa Feldstein is the principal lawyer at Lisa Feldstein Law Office. She is a graduate of Osgoode Hall Law School and the University of Guelph. Lisa practices in the area of Family Health Law™, which includes reproductive law, human rights, privacy, mental health and other health law matters. Lisa has presented at the 519 Church Street Community Centre and PFLAG Canada (York Region), and has been interviewed on Proud FM. She has helped many couples build their families through third party reproduction. Lisa has been teaching negotiation at Osgoode Hall Law School since 2010. She was recently awarded a 2014 Canadian Law Blog award for Best Practitioner blog, and a 2015 Precedent Setter Award.