Yes, you do need to prepare for transgender residents

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Emily Mongan
Emily Mongan

I was a Girl Scout growing up, and despite our slight rivalry with our Boy Scout counterparts (Girl Scout cookies are better than popcorn in every conceivable way, please stop fooling yourselves) I can still appreciate their motto: Be prepared.

It's the reason I keep a snow shovel and blankets in my car, and why I have a tool kit stashed in my kitchen junk drawer. I don't use these things on a daily or even yearly basis, but I keep them on hand anyway so I'm prepared in the event that I do. That preparation is key, and may save me from a sticky situation years down the line.

Preparation is the first thing that popped into my mind as I scrolled through the comments of a recent McKnight's story on the issues facing transgender people as they seek nursing home admission. One reader wondered if a skilled nursing facility should be required to be accommodate transgender residents when the transgender population is still relatively small.

But is it really? While the reader gave his own estimate to the country's transgender population, the real answer is just that: an estimate. It's nearly impossible for us to know just how many transgender people there are in the U.S., for a variety of reasons.

For starters, the U.S. Census Bureau doesn't ask questions relating to gender identity. Another reason is that many transgender people may be reluctant to share their identity; one study found that 71% of transgender people hid their gender to avoid discrimination. Statistics are also lacking on the number of people who come out as transgender later in life.

So while we have a widely accepted estimate of the transgender population in the U.S. — 700,000 people, or 0.2% to 0.3% of the population — the truth is we don't, and may never have, a concrete number. What we do know, however, is that that population is growing; LGBT people currently make up as much as 10% of the U.S. population, and that group is expected to double by 2030.

The issue of making schools, businesses and healthcare facilities more inclusive for transgender people is growing as well, as more media outlets cover the battle over “bathroom” laws and other anti-LGBT legislation.

The takeaway is this: Transgender people will need long-term care as they age. For your facility that “one day” could be tomorrow, or five years in the future. But even with all the unknowns and estimates, it still is important to be prepared — as reports have shown, providers are still ill-equipped when it comes to being able to accommodate the needs of transgender residents, and LGBT residents in general.

Being prepared in this instance doesn't mean roping off a private bed on the off chance that your facility might admit a transgender resident somewhere down the line. But it does mean knowing what tools are available to help you and your staff care for LGBT residents adequately, and with respect and dignity. And that goes for all providers — non-profit religious facilities included.

One place to start is the Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders. SAGE offers resources and training on a variety of topics relating to LGBT seniors, including this guide on creating a welcoming, inclusive facilities. And the majority of the tips included aren't rocket science; they're simple reminders for staff not to gossip about LGBT seniors, or using a resident's chosen pronouns and name — one that's especially important when misgendering has been shown to negatively impact transgender people's mental health.

The Centers for Medicare & Medicaid Services also released a tool last year to help providers build respect for the LGBT seniors.

While there's a chance that your facility may never have a transgender resident, preparation is still crucial. It doesn't mean overhauling your entire facility today. It just means being aware and respectful of the needs a transgender resident may have, and knowing what resources are available to make your facility more accommodating when the time comes.

Follow McKnight's Staff Writer Emily Mongan @emmongan.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.