Trailblazing senator Sarah McBride explains the ‘perpetual fear’ felt by trans people navigating the healthcare system

Sarah McBride

Trailblazing senator elect Sarah McBride has explained the “perpetual fear” felt by trans people navigating the US healthcare system.

McBride made history when she was elected to the Delaware state senate in November, making her the first openly transgender senator in United States history, and the highest ranking elected trans official in the country.

In an interview with Dr Danielle Jones, a trans-inclusive American gynaecologist known on her YouTube channel as Mama Doctor Jones, McBride broke down why trans people find the US healthcare system so scary to navigate.

In the video, titled “A candid interview with Sarah McBride”, she said: “I think a lot of times when we talk about LGBT+ people, particularly trans folks, in care we talk about transition-related care.

“That is obviously a large source of barriers and discrimination that trans people face in healthcare.

“But [there are] challenges that trans people face in broader care, from access to a gynaecologist to treatment for cancer. There is this perpetual fear.

“Is this provider, is this clinician, someone who embraces and affirms trans people, or doesn’t?”

McBride said that even though “the vast majority of clinicians” treat trans people equally, there is always “the fear of whether this person’s personal prejudice could result, even subconsciously, in substandard care”.

She added: “Because we know the data is clear that is can and it does.”

Referencing her late husband Andy, who passed away from cancer four days after they were married, the Delaware state senator said: “I know with Andy, there was that constant fear in the back of our minds: ‘Will the next physician or will the next nurse… not support and embrace trans folks?'”

This fear, McBride said, not only affects the mental wellbeing of trans folk, but also their physical health.

She continued: “Navigating the healthcare system, navigating particularly serious illness, is overwhelming, period.

“But then to throw on top of that the fear of discrimination that might lurk around any corner, that gets in the way of a patient being able to really focus on the job ahead of them of trying to get well and taking care of their health.

“That fear is real and is has a tangible impact on our actual physical outcomes when you’re struggling with that fear, when you have that distraction getting in the way of our ability to get better and stay well.”

Asked by Jones how healthcare providers can help to assuage this fear, McBride said: “It’s so important, no matter the care you’re providing, to be thinking: ‘How am I sending the message that this is an affirming, inclusive space?’

“It could be going through LGBT+ cultural competency training and making clear that you’re an ally, it could be a step as simple and straightforward as that.

“But it’s so important that no matter the care, you recognise that trans people are going to be accessing that care, they need that care.

“And no matter how good and decent you are as a person, and you know you are, the new patient isn’t going to necessarily know that, and it’s helpful to try to make it clear.”