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  • Gender Identity Requires Re-thinking Routine Radiology Procedures

    Medical radiology technologists discuss the importance of treating transgender patients professionally and respectfully. By Nick Klenske

    October 1, 2017

    Performing what she assumed to be a routine x-ray on Henry, an eight-year-old boy, Sidsel Pedersen, a medical radiologic technologist (MRT) and instructor at the Southern Alberta Institute of Technology, was given some surprising news. After calling Henry away from the changing room, the child’s mother pulled Pedersen aside and informed her that Henry in fact, identifies as a girl and prefers to go by Harriet.

    Although the x-ray was only of Harriet’s wrist, Pedersen began thinking about how transgender patients could affect traditional radiology practices. For instance, because MRTs use different techniques to shield male and female reproductive organs from radiation, in the case of a transgender patient, the radiographer will first have to confirm where the patient’s reproductive organs are located.

    When discussing this situation with her colleague Virginia Sanders, MRT, the two had an in-depth conversation about the changing gender landscape and how routine x-ray exams may differ when the patient is transgender. “How can MRTs treat transgender patients both professionally and respectfully?” they asked.

    It became evident that more and more MRTs are facing similar questions.

    To help MRTs better understand the topic and their responsibility to their transgender patients, Sanders and Pedersen will present the session “Gender Diversity — It’s the Parts that Matter” during RSNA 2017. The session is one of the American Society of Radiologic Technologists (ASRT)/RSNA sessions planned for RSNA 2017. (See sidebar.)

    The Changing Gender Landscape

    In investigating the issue, the two MRTs found that, although various studies examined healthcare for transgender patients, none of the research addressed the specific issue of communicating with patients about reproductive organs. These studies did reveal the marginalization of this community, and more specifically, highlighted the disparity in healthcare services for transgender patients vs. cisgender patients (people whose gender identity matches the sex that they were assigned at birth).

    “Traditionally, the model of gender has been binary — male and female — but that landscape is completely different now,” Sanders said. “Awareness of this shifting landscape is important for those of us in healthcare, particularly with transgender patients, as they may not identify and present the same as their biological sex.”

    As an example of the impact on standard practice, MRTs can now utilize a gender continuum that contains many different categories of gender variance, such as sex-to-gender congruency and sex-to-gender non-congruencies. “It is imperative for MRTs to be aware of the diversity within the gender continuum as we are the ones delivering ionizing radiation to the public,” Pedersen said.

    “For those of us in diagnostic imaging, the incongruence between a patient’s gender expression, gender identity and biological sex means we could potentially shield the wrong reproductive organs from ionizing radiation during certain x-ray exams,” Sanders said. “We could then be negligent in protecting the public from potentially harmful radiation.”

    Best Practices for Transgender Patients

    The ASRT/RSNA 2017 presentation will open with a general overview of the issue and discuss how gender variance affects shielding reproductive organs from ionizing radiation. Presenters will also offer an in-depth look at the new gender continuum and best practices for ensuring that all patients feel respected and heard while receiving a high level of care.

    Attendees will gain practical tips, such as adapting questionnaires and communications so that the MRT can determine the location of the patient’s reproductive organs in a respectful and dignified way.

    The session will close with a look at what clinics and hospitals can do to create a gender-friendly environment.

    ASRT@RSNA 2017 Sessions

    “Gender Diversity – It’s the Parts that Matter,” is one of the ASRT@RSNA 2017 sessions to be held on Wednesday and Thursday, Nov. 29 and 30. Other sessions include:

    • “Where Does the Radiation Hurt in Low Dose, High Dose and Multiple Dose Radiology?”
    • “Male Breast Cancer: What Lies Beneath”
    • “Understanding Practice and Ethics Standards in a Changing Healthcare Environment”
    • “Cybersecurity for Medical Imaging”

    Add these and all RSNA 2017 courses to My Agenda at Meeting.RSNA.org.