A Closer Look At The Hurdles & Headaches Transgender Patients Face As They Navigate The Medical System January 18, 2017

Tygh Lawrence-Clarke never felt quite right in his own skin. When he started to feel this way as a teenager—that he should be a man, even though his body was female—he had assumed it was simply a product of sexual orientation.


“I didn’t understand my feelings. They didn’t have the word transgender back then, and all I could figure out when I turned 17 was I thought I was a lesbian. Nothing was ever quite right.”

Then one day he was chatting with his wife Sandra about a support group she runs for transgender patients at the VA Medical Center in Manchester—and a lightbulb went off.

“I thought ‘I’m transgender; that’s what’s going on here.’ After that, I went to conventions, learned everything I could, and I just knew, ‘Yeah that’s me!’ I wanted to cry. I finally felt at home. I felt amazing.”

Tygh knew that he wanted to transition right away. But navigating the medical system as a transgender man presented some bumps in the road, including insensitivity from nurses, doctors and other medical professionals—the very people Tygh thought would be most equipped to handle transgender issues.

The most frustrating thing for Tygh is being constantly misgendered. One day, four days after major surgery, he had to out himself to an entire waiting room of patients after the intake nurse mistakenly assumed Sandra was the patient because Tygh’s driver’s license still showed a female name and gender. There was no effort to discretely mark Tygh’s gender identity on his chart, so he had to correct every new provider he saw.


The constant misgendering moved from inconvenient to embarrassing when Tygh went in for a follow-up appointment. The intake personnel handed him a pink medical gown and led him into a female-only changing room. He says the women were appalled—and he was mortified.

Even after Tygh had his name and gender changed on his driver’s license, the misgendering continued to happen almost every time Tygh saw a doctor—even at a routine dental appointment. That’s because there is no way to signal gender identity on his insurance documents except through changing the sex listed. The process and requirements for that aren’t clear, and Sandra and Tygh aren’t sure they’d want to do that anyway since it could jeopardize his ability to receive certain types of care in the future.

Sandra doesn’t understand why insurance companies have been so slow to change their recordkeeping. She knows it’s possible, considering the VA, one of the country’s largest health systems, has created a gender marking system for patient records.

15727098_10212110781625211_625767561829108418_n“Any kind of electronic health record should be modified,” she said. “When we were married, and I added Tygh to my federal insurance, their computer system would not accept two females as being married and eligible for insurance coverage. But they adapted then—so they can do it now. If the VA, with it’s huge bureaucracy, can do this, others should be able to.”

For many transgender people, being misgendered is a deeply hurtful experience. Over time, it can lead to depression and even thoughts of suicide. These challenges haven’t stopped Tygh—but he says being misgendered at the doctor’s office can drive some  transgender people to forgo care altogether.

“This stuff needs to change. Transgender people are not getting health care because they’re afraid to go, and they get outed—who knows what might happen with people who are more dysphoric,” he said. “But I’m not shying away; I’m going to do this—I’m going to fight the fight.”