Inside NYP: Brandon Elgün
How one employee, who is transgender, is working to ensure all patients are treated with dignity and respect.
I came out as a lesbian in 1996. At the time, I was living in rural, upstate New York, which was a bit of a challenge. And then I came to a deeper realization that I was also a transgender person. Because of that, slowly over my junior and senior years in high school, I had to come out again, and that’s when it got pretty bad.
The gym teacher referred to me as “it” in front of our entire classroom. I asked if I could wear some trunks over my bathing suit in swim class and was told no — that that was a health code violation, which is obviously ridiculous. My name and pronouns were not respected at all. I was pretty shut down.
I was also told that I couldn’t graduate if I showed up wearing a suit, but I did just that, and I was able to walk across the stage to collect my diploma.
These experiences have underscored the importance of treating the patients I see in my job with dignity and respect.
I was inspired to go into healthcare during college, when I worked at a needle exchange at Tompkins County Prevention Point in Ithaca, New York, which was a part of the Southern Tier AIDS Program, where I was later employed. I did a lot of work in educating the transgender participants we saw on how to safely administer their intermuscular hormone injections. I created a supplemental pamphlet that walked participants through injection, step-by-step, from selecting the appropriate injection site to cleaning to taking care of the site after. There was very sparse literature or other resources available for participants at that time.
As prevention coordinator at the Center for Special Studies, NewYork-Presbyterian’s HIV clinic in Chelsea, which provides high-quality, comprehensive HIV prevention and treatment, some of my work involves having really open, honest, nonjudgmental conversations with people about their sexuality and sexual practices. At CSS, I help make sure people have access to medications that can help prevent HIV either before or after being exposed to the virus, but I also help people navigate the healthcare system, navigate insurance, and support them through taking their medications. Although only a few patients are trans-identified, we ask for and respect names and pronouns of all our patients. It’s amazing to watch folks open up and realize that they don’t have to hide or omit things. It also allows us to discuss healthcare that makes sense for them.
I model some of the way I provide healthcare based on my past healthcare experiences. In college, I received care at Planned Parenthood of the Southern Finger Lakes. It was one of the first branches to really work on transgender healthcare and make sure their folks were competent. I went there seeking nongender-related care, and they treated me with dignity and respect. They honored my whole identity, and it had a great impact. I’d never had a healthcare provider ask me what my pronouns were before. It inspired me to help ensure that other transgender and queer individuals were able to have that same experience of healthcare.
My observations at work, as well as the challenges I’ve experienced being a transgender person in the workplace, are driving me to help NewYork-Presbyterian raise awareness about transgender issues and make changes to the culture surrounding transgender staff and patients. I’m doing this as part of working groups I’ve been invited to join here in which we’re looking at ways we can promote policies that are inclusive of transgender patients.
Some of the changes we envision may sound small, but they are actually huge. For example, one of the challenges we have here — well, a challenge you have anywhere — is that healthcare providers don’t necessarily understand pronouns. Especially if they’re not he and she. If a patient’s pronouns are they and them, there are a lot of people in the hospital who struggle with that and don’t know how to consistently refer to a patient. If we want to truly honor our patients, respect their dignity, and earn their trust, then we have to ask for their pronouns and figure out a way to put pronouns in the electronic medical record so they’re respected all the time.
Another area is changing the format of the patient wristbands to remove the gender markers that appear on them. The goal is to remove the “M” or “F” from the wristbands so we don’t “out” a patient to those who may see the band and realize the patient is transgender. More importantly, if we are putting the message out there that we will honor someone’s identity, but then make them wear a wristband with the wrong name and gender marker, what does that say to this patient?
I would also love to see us do something bigger. Training could help healthcare providers better understand the needs of transgender people who take hormones, so we don’t have people saying, “You know what? You have to go somewhere else for that particular piece of your healthcare.” In order to ensure holistic care with positive outcomes, we need to address and honor the whole person. I really want to see that happen and I want to be part of that, but to get there we have to first make sure that the systems are in place to support people coming through the door.
My experience has shaped my desire to work with marginalized and stigmatized folks in general, not just transgender patients. People shouldn’t have to fear judgment or hide very important parts of themselves when seeking care. A lot of it just comes down to the ways that I have been treated in healthcare, both good and bad. These moments have shaped who I am as a provider and what I want to do for other people: to make sure that the bad experiences don’t happen and the good experiences do.
Brandon Elgün is a prevention coordinator at NewYork-Presbyterian’s Center for Special Studies in Chelsea. He is a candidate for a Master of Public Health from the State University of New York at Albany.