Transgender Health Care at Virginia Mason: Providers are ‘Driven to Do This Work’

Longtime Virginia Mason patient Samantha Forney and the nurse caring for her sat down to talk. The nurse had made a mistake by referring to Samantha, who is a transgender woman, with male pronouns. Samantha saw an opportunity for teaching, with a receptive caregiver.

“To me it’s much more important to make something a positive learning experience,” said Samantha. “Getting my feelings hurt or being angry won’t make things better for the next person.”

Samantha.Forney

Samantha Forney

Samantha’s steadfast advocacy for transgender health care first caught the attention of her primary care doctor, who asked if she would join the guiding team working to develop transgender health care at Virginia Mason. Eager to be involved, Samantha applied to become a Patient-Family Partner (PFP), a unique volunteer program that invites patients and families to be active co-designers of patient care. In her new role, Samantha made an impression on the PFP clinical team: would she be willing to share her personal story while presenting to the medical center’s board of directors?

Samantha began work on her board presentation in the summer of 2017, a time when Virginia Mason’s development of Transgender Health Services was well underway. A bolstered strategy to support diversity and the individual needs of patients ignited in 2016, when the organization signed on to the American Hospital Association Equity of Care pledge: a national call for eliminating health care disparities among patient populations. A commitment to providing affirming care for lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people spawned system-wide changes, from policies and staff training, to new care guidelines across medical specialties.

Virginia Mason’s health equity work was already changing the organization when Samantha presented to the board in September 2017, but sharing her own experience shed light on the human toll of lifelong struggle, loss and fighting for acceptance. It was the compassionate care that Virginia Mason had already given her, she said, that made her certain they could be leaders in providing the support and health services transgender people are often denied.

“Virginia Mason has these wonderful providers who really do care, they are driven to do this work.” — Samantha Forney 

“I told the board about both positive and negative experiences I’ve had,” said Samantha. “But Virginia Mason has these wonderful providers who really do care, they are driven to do this work. I see the team come together for my appointments. It’s a culture, a willingness to collaborate with each other and with other doctors that treat me. It’s so amazing to find that.”

It was Virginia Mason’s destiny, Samantha put forward to the board that day, to welcome a chronically mistreated community into the dignity and safety of comprehensive medical care. Now after more than a year of advising the organization as a PFP and working with the transgender service line (TSL) guiding team, Samantha admits being in awe of what people are doing, both on the clinical and administrative sides. It’s their energy, professionalism and humanity, she says, that motivates her to personally connect with more Virginia Mason providers.

“Every time I see a new provider I say ‘before I go, can I ask you to please consider joining the WPATH [World Professional Association for Transgender Health]?’” says Samantha. “And I also ask them to join the guiding team, because we need them.”

A face-to-face connection can open people to new ideas, a power that drives the TSL guiding team. Providers from across the patient care spectrum – from clinical staff to administrators to physicians and surgeons – join with patient partners to learn from each other as they plan improvements to the care experience.

“Guiding team meetings are a safe space for clinicians and staff members to ask questions beyond their own areas of expertise,” says Maria Rearick, director, Ambulatory Services at Virginia Mason. “It’s a unique forum, to have open discussions across care teams for sharing our progress and where we see opportunities.”

As transgender health care services at Virginia Mason grow across specialties – including primary care, speech-language pathology, gynecology, facial surgery, endocrinology, and urology – the voices of patients like Samantha ensure that awareness and sensitivity toward all LGBTQ patients keeps growing too. Working goals for the TSL guiding team include more staff education through facilitated discussions, creating a welcoming environment with everything from all-gender restrooms to affirming medical forms, and continued outreach to partner organizations and the LGBTQ community.

“This a new frontier in medicine,” says Samantha. “I’m very proud of the giant step Virginia Mason has taken in this direction. They are passionate about equity in health care and making things better for people. It’s an exciting time.”


Transgender Health Services at Virginia Mason offers a range of primary and specialty care services for transgender and non-binary patients. We provide gender-affirming, evidence-based care to meet individual needs and goals in a welcoming and supportive environment.    

 

Comments

  1. David Aboulafia MD says:

    I am very proud of the role that Samantha has taken to help Virginia Mason address disparities in care for our transgender patients and her efforts to educate our providers during her clinic visits. She is a real inspiration for me !!!

  2. Lisa Leitzelar says:

    I just read “Redefining Realness” by Janet Mock. Such a great read – maybe VM can have a facilitated discussion/book club to increase our understanding of the issues and perspective of the trans community.

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