Transgender patients find health care on Rutgers student’s app

Imagine checking in for an appointment with your primary care doctor, and you notice your forms show the wrong gender marker. You might feel confused, hurt, question how well your doctor knows you or how to offer you proper care. 

Transgender, nonbinary and other gender diverse people fear instances like this when they seek health care, like a nurse calling their wrong name or receiving incorrect treatment because of their outdated gender marker. Finding providers who know how to treat non-cisgender people would be ideal, but that’s not a simple feat.

Typing key words for transgender-affirming care in a search engine calls up LGBTQ-specific providers. It’s more difficult to find everyday health care services, like dentists or primary care doctors, who respect and understand gender diverse patients.

Creators behind an upcoming app, TranZap, want to make that search simpler for gender diverse people seeking care. 

Gender-affirming providers are not only doctors who perform plastic surgeries or administer hormone replacement therapy. They’re doctors, nurses, front desk staff and everyone in a medical office who know how to respectfully care for gender diverse patients. 

Second year Rutgers Robert Wood Johnson Medical School student Taylor Chiang is beta testing TranZap, an app that allows transgender people to review healthcare providers as a way to help other trans people find medical professionals who respect their identities. Chiang developed the app concept and is pictured with their mentor, Dr. Gloria Bachmann, a professor of Obstetrics & Gynecology and Associate Dean for Women Health at Rutgers Robert Wood Johnson Medical School.

Some resources exist that help transgender people find plastic surgeons or endocrinologists who affirm people’s gender physically. Taylor Chiang, a second year student at Rutgers Robert Wood Johnson Medical School who came up with TranZap, wants people to find “gender-affirming [providers] to get regular old routine care.”

“A big barrier to health care is being afraid that you’re going to be discriminated against or not knowing information,” Chiang said. “Whether or not a primary care provider is gender-affirming, that information is lacking.”

Transgender people face a high risk of physical and mental health problems, but are “consistently and systemically underserved by the American medical system,” a Center for American Progress report reads. Some 62% of transgender respondents said they worried about being judged based on their sexual orientation or gender identity in health care settings, according to TransPop survey results.

Second year Rutgers Robert Wood Johnson Medical School student Taylor Chiang, not pictured, is beta testing TranZap, an app that allows transgender people to review healthcare providers as a way to help other trans people find medical professionals who respect their identities.

Chiang experienced uncomfortable conversations surrounding their identity in health care settings before. They typically searched for providers who accepted their insurance, or heard about affirming providers via word of mouth. Sometimes, they “risked” the provider lacking knowledge about caring for and talking to transgender and gay patients. 

They had connections to transgender people seeking similar care, but they wondered about gender diverse people who didn’t have that community, who struggled to find health care. That

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Biden uses Trump-era policy to expand health care for transgender Coloradans

The Biden administration is using a Trump-era policy to approve the expansion of health care coverage for transgender Coloradans, forcing many of the state’s private insurers to cover gender-affirming care.

Former President Donald Trump’s 2018 policy allows states to redefine the essential health care benefits insurers are required to cover under the Affordable Care Act. On Tuesday, the Biden administration used it to approve Colorado’s request to add gender-affirming care among its health plans’ guaranteed benefits.

The move will force individual and small-group insurers to cover transition-related procedures, including hormone therapy, breast augmentation and laser hair removal, starting Jan. 1, 2023.

Federal officials and Colorado Gov. Jared Polis, one of two openly LGBTQ governors, said they hoped the measure would serve as a model to expand gender-affirming care in other states. The Biden administration also cited discriminatory barriers that transgender Americans frequently face when they seek transition-related care, often described as cosmetic.

“Health care should be in reach for everyone; by guaranteeing transgender individuals can access recommended care, we’re one step closer to making this a reality,” Health and Human Services Secretary Xavier Becerra said in a statement Tuesday. “I am proud to stand with Colorado to remove barriers that have historically made it difficult for transgender people to access health coverage and medical care.”

Medicaid covers gender-affirming care in more than a dozen states, including Colorado. But only a handful of states, including Massachusetts and Washington, have policies similar to the new Colorado measure, requiring many private insurers to cover transition-related care.

As a result, nearly half of transgender Americans — including 54 percent of trans people of color — say that their health insurers covered only some of their gender-affirming care or that they had no providers in network, according to a survey last year by the Center for American Progress. The report found that 46 percent of trans respondents and 56 percent of trans respondents of color were denied gender-affirming care by their insurers.

Dr. Alex Keuroghlian, the director of the National LGBTQIA+ Health Education Center at Boston’s Fenway Institute, who works directly with transgender patients, applauded the Biden administration’s new measure.

“What we’ve learned the hard way is that private insurers and employers won’t necessarily have these equitable policies around coverage of medically necessary gender-affirming care without the government enforcing such expectations,” he said.

Keuroghlian said that when Massachusetts similarly expanded coverage for transgender patients in

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Medical student creates app for improving transgender individuals’ experience with health care

Rutgers is endorsing the beta launch of TranZap, a web-based application designed by a Rutgers medical student for the transgender community to leave reviews for health care providers, according to a press release.

Taylor Chiang, co-creator of TranZap and a second-year student at the Rutgers Robert Wood Johnson Medical School, discussed their role in the project and what made them want to create this resource.

They said that as a transgender individual, they think many aspects of health care need improvement in terms of treating the transgender community.

“A lot of the time, trans folks do avoid health care because they are afraid of the barriers that they might face,” Chiang said. “Those barriers can include financial barriers like straight-up access to care, but also discrimination, harassment, trying to explain what it means to be transgender, microaggressions, things like that. I think a lot of those things are off-putting to trans folks in terms of just seeking everyday care.”

Their role has consisted of advertising, creating protocols, getting feedback and more while the co-founder, Eli Lucherini, a doctoral candidate at Princeton University, has been working on the web development and coding for the app, Chiang said.

When inquiring over social media about which aspects of health care need improvement to the transgender community, Chiang often heard from community members that they do not know where to get suitable referrals or find gender-affirming health care providers, they said.

To address these issues, the app contains two main features, which are the ability to leave a review of a health care provider one has recently seen and the ability to look up those reviews once they have been left in the app, Chiang said. People can also browse for a particular physician.

Chiang said they like to see the app as similar to Yelp, except for transgender people and specific to health care. They said the reviews that are left on TranZap cover the overall experience of transgender patients with certain health care providers and answer specific questions to crowdsource information in one place.

“Did this provider ask what your preferred name was? Did this provider ask what your pronouns were? Did they use the pronouns once they asked what those pronouns were?’” Chiang said. “Those are very easy yes or no questions — they either did it or they didn’t do it — and we had some other questions that people

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