This article examines how the lack of recognition of nonbinary identities within the healthcare system can result in discrimination, misdiagnosis, and mistreatment of nonbinary patients. Nonbinary individuals are those who identify as neither male nor female, and may have diverse gender identities beyond this binary. The American Medical Association recognizes that "gender identity is separate from sexual orientation" and notes that many nonbinary people face "barriers to care."
The ethical tension in medical care for nonbinary individuals lies primarily in the question of whether to respect an individual's self-identified gender identity or adhere to traditional biological categories such as male and female. In practice, most hospitals require patients to specify their gender when filling out paperwork, leading to some doctors refusing treatment if they cannot categorize a patient. This can cause significant harm to nonbinary people seeking routine care, such as pregnancy testing.
Certain body parts may be deemed medically necessary for transitioning but not covered by insurance. These policies reflect societal biases against nonbinary genders, which prioritize the normative assumption that gender is binary.
There are ethical concerns about the privacy rights of nonbinary individuals during hospitalization. Some transgender individuals experience violence or discrimination due to their gender identity, making them fearful of sharing personal information with doctors. Nonbinary individuals may also feel uncomfortable disclosing intimate details to providers who are unfamiliar with their identity or may not use appropriate pronouns. This highlights the need for cultural competency training for healthcare professionals regarding nonbinary identities.
To address these challenges, organizations like Outside In provide LGBTQ+ health services for low-income patients. They offer hormone therapy, mental health counseling, and primary care in a safe environment where all identities are accepted.
This specialized care often comes at a cost, limiting accessibility for many nonbinary people.
The tensions between medical care and nonbinary identities reveal broader issues surrounding sexism, heteronormativity, and cisnormativity. Gender-affirming surgery should be covered by insurance, while nonbinary patients' needs should not be neglected due to their lack of visibility within the system. Medical institutions must work towards inclusivity and accountability to ensure that everyone receives quality care regardless of their identity.