Dental News - Interview: “Most oral health care providers treat TGNC patients with respect”

Iveta Ramonaite, Dental Tribune International

Thu. 22. August 2019

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There is currently little information regarding the oral health care experiences of transgender and gender nonconforming (TGNC) people. Dental Tribune International (DTI) spoke with Dr. Scott Schwartz, a pediatric dentist in the Division of Pediatric Dentistry and Orthodontics at Cincinnati Children’s Hospital Medical Center and assistant professor in the Department of Pediatrics at the University of Cincinnati, on the topic. Schwartz and his colleagues have recently conducted a study on TGNC people’s experiences with oral health care providers and he shared the key findings with DTI.

Dr. Schwartz, how did you become interested in this topic?

There are a variety of documented health disparities and issues related to access to care among the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) population. This group is highly vulnerable for a variety of reasons, including the fear of discrimination and the limited protection against it in the health care setting and the lack of education among health care providers about providing culturally competent care. Those who identify as TGNC are even less well understood, in part owing to the small population size. Most of our current understanding of LGBTQ+ individuals comes from the medical literature, with very little scientific inquiry in the oral health care arena. This is where my interest initiated—in seeking to understand more about the oral health care of an underinvestigated, vulnerable population. The Transgender Clinic, housed within the Division of Adolescent and Transition Medicine at Cincinnati Children’s Hospital Center, provides state-of-the-art care to these young people. Many of them, together with their families, want to participate in research activities to forward the general understanding of gender identity and improve the quality of care delivered.

Do you think that TGNC people are often treated differently from other dental patients?

Prior to completing the study, there was reason, based on existing medical literature, to suspect that TGNC individuals were treated differently from their cisgender counterparts. The results of our study show that most oral health care providers treat TGNC patients with respect and want to make the experience seamless and comfortable. In the oral health care sphere, I do not believe that most TGNC patients are treated differently from other patients, and if they are, it is often originating from a well-intentioned member of the team who may not have a full understanding of the TGNC community and related best practices. In these instances, direction from the patient or a family member generally ameliorates the issue going forward.

According to the results of your study, what causes the most stress and anxiety in TGNC people during dental visits?

According to the results of our study, the most stress and anxiety for patients who identify as TGNC and their families comes with the uncertainty of acceptance from the oral health care team, either when seeking a new provider or before the visit during which they may come out. Patients or their caregivers should be given a private space to disclose such personal information, so open bay arrangements may not be best for visits when this is reviewed.

How could dentists make TGNC people’s dental visits more enjoyable?

Dentists can make TGNC patients feel at ease in a variety of ways. External and internal marketing strategies can indicate acceptance both before a patient arrives at your office and when he or she is already there. Blog posts, nondiscriminatory statements that include gender identity, or small gay or trans pride decals posted on websites or in the waiting area let prospective and current patients know that their identity is accepted. Small modifications to intake and medical history forms, such as including a space for “Legal Name” and “Chosen Name,” a space for pronouns and another one for sex, can also make them feel more inclusive. Once a patient discloses his or her gender identity, the entire team should use the correct pronouns and chosen name. As long as everyone is making a concerted effort to refer to the patient correctly, most patients are sensitive to the fact that the team may have known them for several years and making changes in their vernacular may be difficult.

Editorial note: Schwartz’s study, titled “‘I just want to be treated like a normal person’: Oral health care experiences of transgender adolescents and young adults,” was published in the September 2019 issue of the Journal of the American Dental Association.

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