Presentation
PS8 - Opportunities and Challenges in Designing for Psychosocial Safety of Transgender and Non-Binary Patients
SessionPoster Session 1
DescriptionThe science and practice of patient safety have largely focused on preventing direct physical harm, such as death, falls, pressure ulcers, healthcare-acquired infections, and adverse drug events. However, preventable psychosocial harm, or avoidable patient suffering, has been relatively overlooked. This oversight persists despite growing evidence that psychosocial harm is pervasive and profoundly impacts patients' health and wellbeing.
People from minoritized and stigmatized groups face an increased risk of psychosocial patient harm. Not only are these populations more likely to be exposed to psychosocial adverse events in healthcare settings, but they also face increased vulnerability to harm because of psychosocial stressors imposed outside the healthcare environment. Harm to transgender and non-binary (TGNB) individuals is particularly ubiquitous, even in the context of other high-risk groups.
Because of widespread societal stigma surrounding gender nonconformity, defined as “the extent to which a person’s gender identity, role, or expression diverges from the cultural norms associated with a particular sex”, many TGNB individuals live on the margins of society. They face discrimination, exclusion, and violence, and often experience significant barriers to accessing appropriate healthcare. This includes barriers to accessing care specific to their gender health needs, like hormone therapy or gender-affirming surgery, as well as general medical care for unrelated conditions (e.g., orthopedic surgery post-op visit after a broken bone). TGNB individuals are frequently subjected to mistreatment or discrimination within healthcare settings, which is harmful in its own right and often leads them to delay or avoid care entirely. For example, more than 30% of TGNB individuals report delaying or not seeking healthcare due to fear of discrimination. Such avoidance can result in diagnostic delays, preventable disease progression, and overall poor health outcomes.
Addressing these health inequities and improving the psychosocial safety of TGNB patients requires a systems-level, person-centered approach that emphasizes active participation and partnership with patients, caregivers, clinicians, and staff. The goal of our AHRQ-funded TRANS-SAFE Patient Safety Learning Laboratory is to advance the science and practice of patient safety by developing interventions aimed at reducing psychosocial harm and improving outcomes for TGNB patients, one of the most stigmatized and vulnerable populations in healthcare today. Our approach, rooted in participatory design, prioritizes the inclusion of diverse voices in the development and implementation of healthcare policies, processes, and solutions. By fostering an inclusive, collaborative environment, the system can better address psychosocial harm and promote equity.
This panel will bring together diverse perspectives from clinical practitioners, patient and community advocates, and experts in human factors and risk management to discuss actionable strategies for improving the psychosocial safety of TGNB individuals in healthcare.
Our discussion will feature prominent TRANS-SAFE members:
1. Hanna Barton, PhD (They/them) - Postdoctoral Research Associate, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI
2. Tara Cohen, PhD (She/her)– Director, Surgical Safety and Human Factors Research, Jim and Eleanor Randall Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
3. Alan Card, PhD (He/him) – Assistant Professor, Global Health Management & Policy, College of Health and Human Services, School of Public Health, San Diego State University, San Diego, CA
4. Jodi Traver, PhD, RN, NE & NPD (She/her) – Nursing Professional Development Practitioner, Department of Nursing, Cedars-Sinai Medical Center, Los Angeles, CA
5. Jennifer Anger, MD, MPH (She/her) – Professor and Vice Chair of Research, Department of Urology, University of California San Diego Health, San Diego, CA
6. Rai Khamisa, LCSW (They/them) – Gender Health Program Director, University of California San Diego Health, San Diego, CA
The panel will be moderated by Dr. Barton, and our discussion will include the following perspectives:
Clinical Perspective
Dr. Jennifer Anger, a gender-affirming care surgeon, and Dr. Jodi Traver, a nursing professional development practitioner, will share their experiences with and insights on the clinical challenges of providing gender-affirming care in the current healthcare and political environment. Drs. Anger and Traver will discuss barriers to gender-inclusive education and practices among healthcare providers and consequences of these barriers.
Patient/Community Advocate Perspective
Rai Khamisa, a licensed clinical social worker and Program Director of a large academic medical center’s gender health program, will provide insight into the lived experiences of TGNB patients, highlighting the psychosocial harm that TGNB encounter in healthcare settings and how these experiences impact their willingness to seek care.
Research Perspective
Dr. Tara Cohen, a human factors expert, and Dr. Alan Card, a specialist in patient safety and risk management, will discuss their research from the AHRQ-Funded TRANS SAFE Patient Safety Learning Lab. They will focus on identifying and mitigating psychosocial harm in healthcare through human factors and systems engineering approaches, offering evidence-based recommendations for creating safer, more inclusive environments for TGNB patients.
People from minoritized and stigmatized groups face an increased risk of psychosocial patient harm. Not only are these populations more likely to be exposed to psychosocial adverse events in healthcare settings, but they also face increased vulnerability to harm because of psychosocial stressors imposed outside the healthcare environment. Harm to transgender and non-binary (TGNB) individuals is particularly ubiquitous, even in the context of other high-risk groups.
Because of widespread societal stigma surrounding gender nonconformity, defined as “the extent to which a person’s gender identity, role, or expression diverges from the cultural norms associated with a particular sex”, many TGNB individuals live on the margins of society. They face discrimination, exclusion, and violence, and often experience significant barriers to accessing appropriate healthcare. This includes barriers to accessing care specific to their gender health needs, like hormone therapy or gender-affirming surgery, as well as general medical care for unrelated conditions (e.g., orthopedic surgery post-op visit after a broken bone). TGNB individuals are frequently subjected to mistreatment or discrimination within healthcare settings, which is harmful in its own right and often leads them to delay or avoid care entirely. For example, more than 30% of TGNB individuals report delaying or not seeking healthcare due to fear of discrimination. Such avoidance can result in diagnostic delays, preventable disease progression, and overall poor health outcomes.
Addressing these health inequities and improving the psychosocial safety of TGNB patients requires a systems-level, person-centered approach that emphasizes active participation and partnership with patients, caregivers, clinicians, and staff. The goal of our AHRQ-funded TRANS-SAFE Patient Safety Learning Laboratory is to advance the science and practice of patient safety by developing interventions aimed at reducing psychosocial harm and improving outcomes for TGNB patients, one of the most stigmatized and vulnerable populations in healthcare today. Our approach, rooted in participatory design, prioritizes the inclusion of diverse voices in the development and implementation of healthcare policies, processes, and solutions. By fostering an inclusive, collaborative environment, the system can better address psychosocial harm and promote equity.
This panel will bring together diverse perspectives from clinical practitioners, patient and community advocates, and experts in human factors and risk management to discuss actionable strategies for improving the psychosocial safety of TGNB individuals in healthcare.
Our discussion will feature prominent TRANS-SAFE members:
1. Hanna Barton, PhD (They/them) - Postdoctoral Research Associate, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI
2. Tara Cohen, PhD (She/her)– Director, Surgical Safety and Human Factors Research, Jim and Eleanor Randall Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
3. Alan Card, PhD (He/him) – Assistant Professor, Global Health Management & Policy, College of Health and Human Services, School of Public Health, San Diego State University, San Diego, CA
4. Jodi Traver, PhD, RN, NE & NPD (She/her) – Nursing Professional Development Practitioner, Department of Nursing, Cedars-Sinai Medical Center, Los Angeles, CA
5. Jennifer Anger, MD, MPH (She/her) – Professor and Vice Chair of Research, Department of Urology, University of California San Diego Health, San Diego, CA
6. Rai Khamisa, LCSW (They/them) – Gender Health Program Director, University of California San Diego Health, San Diego, CA
The panel will be moderated by Dr. Barton, and our discussion will include the following perspectives:
Clinical Perspective
Dr. Jennifer Anger, a gender-affirming care surgeon, and Dr. Jodi Traver, a nursing professional development practitioner, will share their experiences with and insights on the clinical challenges of providing gender-affirming care in the current healthcare and political environment. Drs. Anger and Traver will discuss barriers to gender-inclusive education and practices among healthcare providers and consequences of these barriers.
Patient/Community Advocate Perspective
Rai Khamisa, a licensed clinical social worker and Program Director of a large academic medical center’s gender health program, will provide insight into the lived experiences of TGNB patients, highlighting the psychosocial harm that TGNB encounter in healthcare settings and how these experiences impact their willingness to seek care.
Research Perspective
Dr. Tara Cohen, a human factors expert, and Dr. Alan Card, a specialist in patient safety and risk management, will discuss their research from the AHRQ-Funded TRANS SAFE Patient Safety Learning Lab. They will focus on identifying and mitigating psychosocial harm in healthcare through human factors and systems engineering approaches, offering evidence-based recommendations for creating safer, more inclusive environments for TGNB patients.
Event Type
Poster Presentation
TimeMonday, March 314:45pm - 6:15pm EDT
LocationFrontenac Foyer
Digital Health (DH)
Simulation and Education (SE)
Hospital Environments (HE)
Medical and Drug Delivery Devices (MDD)
Patient Safety and Research Initiatives (PS)