Medical leave has become an increasingly popular option for trans people across the US, as it allows people to leave work when they are suffering from illness.
But some doctors are using leave as a means to restrict access to care and leave trans people even more vulnerable to discrimination.
Medical leave is an option for people with gender dysphoria, a condition where people have a medical condition that affects their sex.
For example, someone with breast cancer or a heart condition may be at risk of developing a heart attack, or a trans woman may have a condition called gender dysphoric disorder.
The US is one of only a few countries in the world to offer leave to people with such conditions.
“I have a lot of people who are not happy about this,” says Dr Liana Baca, a medical oncologist and professor of medicine at the University of California, San Francisco.
“The issue of healthcare access is very real in the US.
It’s one of the most expensive places in the developed world to do medical care, and it’s very hard to get access.”‘
The risk of losing everything’ If a trans person is suffering from a gender dysphorical condition, the risk of loss of access to healthcare and medical treatment is high.
According to the Transgender Law Center, in 2014, the healthcare system in the United States cost the US healthcare system $3.8 trillion.
“You’re more likely to die in the hospital if you’re not there,” says Baca.
“If you are a transwoman, there’s a significant risk that you’ll have to leave and go back to a place where you don’t belong.” “
But Baca is not worried about that. “
If you are a transwoman, there’s a significant risk that you’ll have to leave and go back to a place where you don’t belong.”
But Baca is not worried about that.
“My job is to do a lot more than just treat patients,” she says.
“When I do my job, I’m also teaching a class.
I teach gender-neutral pronouns and pronouns that don’t refer to their biological sex.
And the risk to people who work in the medical profession is huge.” “
It’s the risk I take on when I’m a doctor.
And the risk to people who work in the medical profession is huge.”
Baca’s first time dealing with a patient was in December 2017.
She was working in a surgical unit at the Children’s Hospital of Philadelphia when she noticed that a patient’s left hand was shaking.
“He was not saying ‘I’m sorry.’
He was not acting like he was having a bad day,” she recalls.
“This was not a patient that was in pain.
This was not an individual that was not in pain.”
But that was just the beginning.
“For weeks after that, I had to do every single exam I could think of to make sure that this was not just a medical issue, that this wasn’t an issue of sexual assault, that there was no other reason that this individual could be having a heart problem, and that they were not being attacked,” says the medical doctor.
Baca went on to refer the patient to a physical therapist.
She found out that she would need to take him off the medical leave.
In September 2018, the patient was back in the surgical unit.
Boca went through every step of the patient’s care.
But she was concerned.
“As soon as I took him off leave, I knew that I would lose everything.
The patient would lose access to the medications that were going to help him.”
In October 2018, Baca returned to the patient and they continued to talk about the treatment options.
“We’re trying to figure out what to do, what we’re going to do to try to prevent him from having a future,” she explains.
“What is the best course of action to protect the patient?
What are the best things to do if there is an attack?”
At first, Boca thought that it was the patient who had the most to lose.
“But we’re not in the business of protecting him,” she said.
“So the next step was to figure if we could protect the other patients, and I realized that we could.”
Boca began talking to doctors and social workers about what she could do to protect patients.
The first thing she did was tell her colleagues.
“They had a very clear message,” she remembers.
“No one is going to leave.
They’re not going to take leave, no one is leaving.
And no one’s going to be left behind.”
Bocas approach led to a change in policy at the hospital.
Instead of asking for leave to be taken, the hospital now allowed patients to ask for medical leave to manage their symptoms.
But Boca still didn’t feel confident that she had a legal avenue to sue the hospital or the doctors