The Case of Markesha Transgender Issues
A 22-year-old woman enters the clinic as a first-time client. She tells the receptionist that she has not seen a physician for over 4 years, and she would like a check-up. You are the social worker in the health care setting available to patients that need support, or connection to other resources. She is given an intake form to fill out, on which she reports that her current gender identity is female, and her sex assigned at birth was male. Her first name is Markesha, but her identification lists the first name as Mark.

While she is waiting to see a physician, she enters the womens restroom. Another patient comes out of the womens restroom and reports to the receptionist that she thinks a man is using the womens restroom. The receptionist sends a medical assistant into the womens restroom to see if there is a problem. The medical assistant returns and says everything is all right. Markesha exits the restroom and sits in the waiting area. She seems uncomfortable.
A nurse appears with a chart and calls for Mark. Markesha looks around sheepishly. The nurse calls again for Mark. The patient who had reported a man in the womens room laughs derisively. Markesha gets up and goes to the nurse, who takes her to an exam room. Markesha waits nervously for the physician.

A woman physician enters, greets her pleasantly, and asks, What brings you in today? You, as the social worker, accompany the doctor and are in the patient room. Markesha reports that she has not seen a physician in over 4 years. The physician notices the paperwork and says, Well, welcome to being a man. Markesha is horrified. She thought that this clinic would be different, especially with the form she filled out earlier.
Markesha tells the doctor didnt you see how I identify? Im not a man; Im a woman! The doctor tries to gather herself and says, I am so sorry, I did not see that. This is new to me and I am slowly learning how to treat our patients who identify as transgender. Lets try this again. Markesha accepts her apology and proceeds to tell the physician that she has not seen a physician for many years because of treatment like what just happened. She mentions that she needs a physical for her new job. The physician tells Markesha to let her know if she says something not correct regarding her body parts, offers her a gown (in case she is shy about her body), and begins conducting the physical exam and ordering required tests, explaining each step in the process to her as she does it.

From a social workers perspective, consider the following questions:
1. How would you handle the restroom-related complaints about a transgender patient from other patients?
2. What is the best way to address a patient whose preferred name doesnt match the name on their state-issued identification?