ABSTRACT
This chapter considers the structural, institutional, social, and individual barriers that prevent transgender and gender non-binary patients from receiving good medical care. Many of these barriers stem from two forms of erasure that have been outlined by Bauer et al. (2009). ‘Informational erasure’ refers to a lack of knowledge on the part of healthcare providers regarding trans people, trans experiences, and trans health, and the assumption that such knowledge does not exist. ‘Institutional erasure’ refers to the absence of policies that accommodate trans identities or trans bodies, including the lack of knowledge that such policies are even necessary. Each form of erasure, we argue, results in a failure to recognise and respect trans and non-binary patients and to treat them as full epistemic agents. Drawing on these two forms of erasure, our chapter aims to make sense of the resulting epistemic – as well as non-epistemic – injustices and harms that result for trans and non-binary patients within the context of healthcare, by understanding them as stemming from the double failure to be recognised. While our discussion foregrounds the epistemic dimensions of the harms that result, we also discuss some of the related psychological and health-related consequences of the mistreatment of trans and non-binary patients. Ultimately, our hope is that this chapter helps to motivate a powerful shift in thinking about the importance of trans health and healthcare both at institutional and individual levels.
