Family First Health adding gender identity questions

Katherine Ranzenberger

Family First Health knows how important getting personal care is to one's health. Different groups of people have different health issues, and making sure everyone gets the same level of care is a top priority to Family First, according to the health care provider.

Family First Health's Karen McCraw

Sexual identity and orientation is a very personal issue, said Karen McCraw, director of social services for Family First. It is something that could affect the quality of health care if someone decides not to disclose information.

“We don’t know how we’re doing unless we’re measuring this,” she said.

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Family First is adding three questions to its initial patient interviews to get to know their histories. The questions ask about sexual orientation, gender identity and sex at birth.

“We’re really just asking that information like any other question, like if a patient smokes or wears seat belts,” McCraw said. “We’re really trying to normalize this. This is who our patients are.”

Patients also have the option of filling in their own answers in the categories if they feel they don’t fit any of the given descriptions, she said.

Quality health care has been an issue for members of the lesbian, gay, bisexual and transgender community, according to the Human Rights Campaign, a national organization focused on the civil rights of the LGBT community.

“Health care settings can be stressful enough for children and parents,” an HRC article published on its website in the resources section states. “When a child is worried about being embarrassed or even harassed by unknowing or unfriendly medical professionals and staff, that stress is only compounded.”

McCraw said this stress is something Family First wants to avoid while working with every community member. Jennifer Fernandes, a nurse practitioner in the Hanover Center, is the first provider to implement the questions in the hopes that patients will have a more comfortable experience in the office. Other providers will be trained along the way in how to ask these questions, McCraw said, helping provide better comprehensive care of their patients.

LGBT community members have different health issues that may not relate to cisgender people, or people whose gender aligns with their birth sex. McCraw said this is part of why it's so important to help identify these people.

According to, LGBT youth are 2 to 3 times more likely to attempt suicide. McCraw said identifying someone's gender and sexual orientation can give doctors the chance to do a more in-depth depression screening for these youths.

Lesbians and bisexual females are more likely to be overweight or obese, according to, while gay men are at higher risk of HIV and other sexually transmitted diseases.

Transgender individuals have a higher prevalence of HIV and STDs, victimization, mental health issues and suicides, the website reads. They are also less likely to have health insurance than heterosexual or LGB individuals.

LGBT populations also have the highest rates of tobacco, alcohol, and other drug use.

The HRC has a list of ways doctors and patients can work together to make sure their experience at health care provider offices are positive. One is making sure preferred pronouns and names are used, which is key in keeping people comfortable.

"While every situation will differ, we have worked with transgender youth and their parents as well as allied doctors to detail some ways to help make interactions with medical providers as friendly and respectful as possible," the HRC website reads.

Krystyna McIlroy, a 64-year-old transgender woman from New Salem, said she hasn't had issue with her health care providers.

"(At) York Hospital, everyone is considerate, using my preferred name," she said.

McIlroy, who has given a presentation on transgenderism at York College, said education is key.

Transgender is an umbrella term used to describe people who do not fit into traditional categories, including transsexuals, cross-dressers, bigender and intersexuals, among others, according to a report from the Parents, Families and Friends of Lesbians and Gays (PFLAG)'s Transgender Network.

"Most people have to realize we're just human beings trying to live our lives the best we can," McIlroy said. "Most of the people in the trans community are just everyday, normal people with jobs and families."

Unlike sexual orientation, transgenderism, or gender identity disorder, is still deemed a mental illness by the American Psychiatric Association. There is some disagreement among the transgender community regarding attempts to remove that status, according to PFLAG's report, but there has been some scientific research suggesting biology plays a major role in gender identity.

A 1995 study by The Gender Centre in Australia found that, in a region of the brain known for sex and anxiety responses, male-to-female transgender subjects had a typically female size, while female-to-male transgender subjects had a typically male size.

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