NYU Langone Medical Center is now using a transgender actress "to help medical residents grow more comfortable treating transgender people."
"Standardized patients," or hired actors playing medical patients, are typical when it comes to training residents. But Dr. Richard Greene, the director of gender and health education at the medical center, chose to hire a trans actress to train 23 residents as part of a new study which focuses on the "benefits of using actual transgender actors."
"I took advantage of the opportunity that we hire actors and said, ‘Why can’t we get a trans actor in here?’ And so we did," Green told The Daily Beast, which provides some more details on the training session:
The actress he and his co-authors hired was trained to present as a transgender woman who was experiencing high blood pressure and high levels of potassium—all while taking both the testosterone-suppressing drug spironolactone and the estrogen estradiol. After each simulated encounter with a resident, she rated them on their communication skills and on how adequately they addressed her transgender status.
"The particular challenge the residents faced in this scenario was to sensitively address the patient’s gender identity without fixating on it," notes the publication.
Although the residents received high scores for both communication and patient satisfaction, only 14 of the residents directly addressed the issue of the actress' transgenderism, which was described as a "shortcoming" by the residents.
The study takes credit for offering residents such feedback, which will in turn help them "identify learning needs, including how to ask directly about transition, appropriate terminology, how to admit lack of knowledge to a patient, and putting aside preconceptions about a patient’s identity."
"The pitfall in this case is to only address the hypertension [high blood pressure] and to completely ignore the patient’s gender identity or to go completely in the other direction and make everything about the patient being trans and not focus at all on the medical issues," said Greene.
Notably, Greene explains that although the trans actress' spironolactone was causing higher potassium levels, the doctors were not supposed to fall for the "trap" of telling the actress to stop the hormone therapy in order to lower the potassium levels. This would presumably be too politically incorrect. Though, Greene adds, some patients were too politically correct, ignoring the patients hormone therapy all together:
For example, in this case, the patient’s spironolactone was the obvious culprit for her high potassium levels. And although most residents, Greene told The Daily Beast, did not fall into the “trap” of telling her to stop her medically necessary hormone therapy outright in order to lower the patient’s potassium levels, not enough of them directly made the patient feel comfortable talking about being transgender.
Some tiptoed around the issue for fear of offending, addressing her symptoms in isolation. This avoidance can make transgender patients feel misunderstood.
“The goal is to not leave patients feeling that hole in their care but to have [the physician] say, ‘Talk to me a little bit about your hormones,'" said Greene.
Aside from the work of the trans actress in the medical study, Greene says "every first year medical student in NYU School of Medicine this year went through an OSCE [objective structured clinical examination] where they met a trans patient."
"Starting now," he said, "no one who graduates from NYU School of Medicine can ever say, ‘No, I never met a trans patient while I was in training.'"