My Lunacy post has gotten picked up by Transcending Gender, where several commenters are very upset about the possibility that transfolk might be receiving substandard care in emergency rooms.
In response to this, let me make a few points:
First, ED staff truly do vent out of earshot of all kinds of patients in all kinds of ways; they don't single out sexual minorities. (Trust me on this one!) But they're also professionals, and I've never seen patients -- even overtly obnoxious, aggressive ones who were actively harrassing the staff -- receive anything less than the best medical care that was available. Verbal venting by staff, even (or especially) when it sounds very unkind, is a way of blowing off steam. This is certainly one of the most off-putting aspects of ED culture; as far as I can tell, it's also one of the most universal.
I was unable to spend more time with this particular patient because he (she? I still don't know if the patient was trans or simply cross-dressed) was so consistently surrounded by caregivers asking questions about medical history and current symptoms. This patient was receiving a great deal of focused and professional attention; what little of that I could hear sounded entirely appropriate.
Many months ago, I heard a nurse in the department educating a colleague about the importance of using correct pronouns with a transgendered patient. That nurse, unfortunately, wasn't working the other night. The comments I heard upset me, and still do, but I strongly suspect that they're a function of ignorance, not deliberate malice. (If I get the chance, I'll ask Cool Nurse to speak to the others; they'll listen to CN far more readily than they will to me.)
I'm somewhat educated about these issues because I know several transfolk. Many people don't. I suspect that when I used the word "transgendered" with the one nurse, I got such a blank look because I was literally speaking a foreign language. I suspect that many people, even medical caregivers, don't know enough about the issue even to know what they don't know.
Which brings me back to the question I asked in my original post, which no one's answered yet. What kind of education do emergency-medical personnel get about gender and sexual identity? If they don't get any, how can that be changed? And I'm not just talking about recognizing risk factors and health hazards; I'm talking about learning how to recognize when "difference" isn't a medical risk factor.
Kim has responded to the education question in this feisty post. If all medical staff were like her, the question never would have come up in the first place!