Serving Transgender and Nonbinary Patients with Dignity with Kristie Overstreet, Founder of the Therapy Department: Audio automatically transcribed by Sonix
Serving Transgender and Nonbinary Patients with Dignity with Kristie Overstreet, Founder of the Therapy Department: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket everyone, Saul Marquez here. Today, I have the privilege of hosting the outstanding Dr. Kristie Overstreet. She is a Clinical Psychologist, Psychotherapist, Speaker and Consultant who works with individuals to strengthen their relationship with themselves and others. She specializes in the LGBTQIA+ health care with an emphasis on transgender care. With over 14 years of clinical experience, she has developed best practices for transgender health care. Her mission is to educate every behavioral and health care worker to provide dignity care for the LGBTQ plus community. Dr. Kristie’s written three books on improving relationships, giving a TED talk on transgender health care and is a sought after expert. She’s the creator of the transgender health care dignity model, which we’re going to be touching on today. It’s a training and certification program that teaches medical, behavioral and wellness providers how to care for their patients with dignity. She serves as a national contributor to CNN Inc, Forbes health line, The Washington Post and various other media. She holds a Ph.D. in clinical psychology and a master of arts and professional counseling. It’s such a privilege to have her here today to touch on such an important topic. So with that, Dr. Kristie, I want to welcome you to the podcast.
Kristie Overstreet:
Thanks so much for having me. I’m excited to be here and chat.
Saul Marquez:
Yeah. So it’s a new year. We’ve dealt with a lot of things. And so the topic of caring with dignity is so important. So I’m really excited about our chat today. But before we dive into the work that you do with the dignity model, tell us a little bit more about you and what lights your fire with health care.
Kristie Overstreet:
Well, I am a very passionate person, especially when it comes to people getting their health care needs met because so much of our whole self is based on getting our physical or emotional or sexual and every part of ourselves taken care of, especially when it comes to health care. And so what I started realizing when I first started out a clinician back in 06 is there was a specific area, the community of LGBTQIA plus clients, that we’re trying to get our health care needs in. For example, the facility I was working at and they were running into many barriers and most of the time it came from providers and health care workers not knowing maybe how to use the Right. name or how to work with that individual best. And at that time, I started realizing if we as providers don’t do something about this, these individuals are not going to get the care that they need. So it’s at that time when I started seeing that as providers, we really could use education competencies and making sure that we meet these individuals where they’re at. So that’s what draws me in that I’m passionate about is really arming providers so that they can deliver this care that they love doing.
Saul Marquez:
That’s so great. And you’re right, there’s a lot of confusion. And how do we address folks and how do we really provide medicine in the best way without letting that get in the way? So talk to us a little bit about how you’re adding value to the ecosystem through your health care, the dignity model.
Kristie Overstreet:
Sure. Well, what I find even as a provider myself, we fear what we don’t understand. And that’s what I want from so many providers, whether it’s behavioral health, physical therapists, physicians, anyone in the health care field is a lot of times when they go to to work with a patient, especially in the LGBTQIA, a plus community, that they don’t want to say something so they avoid it or they don’t want to say the wrong thing or they don’t want to come off wrong or they don’t want to accidentally insult somebody. So they just kind of close off and back away because they fear saying the wrong thing. And that’s a big hindrance for these individuals. And so what I started to realize and is we got to have these conversations, we have to educate and we have to bring awareness. And so I started back then in 06 doing some trainings in my facility on how to back in the day, we referred to it as sensitivity training and thank goodness it’s evolved over time. But arming providers to feel confident about knowing the basics of LGBTQIA + care, what are the needs, what to avoid as as how we interact and work with these patients. And so that’s how through the years into my individual work with transgender non binary specific individuals led me to see these competencies and needs. And that’s how the dignity model evolved. I knew that we want to give this care and treat individuals in a positive, affirming dignity way. And developing that model helped me build out those units to arm providers for that care.
Saul Marquez:
Love it. You know, and I think it’s so great you saw an opportunity and you said, you know, want there’s there’s opportunity here to be somebody that can make a difference for people and how they access care. And we talk about access to care and the different challenges that we’re used to hearing about Right. like the social determinants of health. This is one of them. I look at this as one of them, and so talk to us more about it. Help us understand this better. I feel like this episode is about understanding. And so what do you do differently or better than what’s available today? What’s at the core of success here?
Kristie Overstreet:
Well, for me, I find that we meet I say we, meaning us as providers, meet the individual where they’re at and growth means that we meet them in a place of understanding, care and wanting to do the next right thing. But to do that, we have to look at our own bias or prejudice or assumptions that can get in the way. And that’s one of the things that I really pride myself on with building the dignity model – is looking through kind of what’s coming up for you as a provider when you’re going to work with a transgender female. Is there any assumptions that you’re making? Are you automatically thinking they’re going to be there to access a medical transition for hormonal care? And let’s say that you’re not feeling competent in doing that, do you kind of back away and don’t bring it up or do you find a referral? So we’re looking at assumptions, bias, understanding, and for our own self noticing that whatever is going on for us so easily gets on our patient, you know what I mean? So, like, if we’re feeling uncomfortable, we’re going to likely calls our patients to feel uncomfortable. And the more that we can show up feeling confident and competent, we’re going to deliver better care. And so breaking down those eight units of the model, we cover basics, social, medical, transition needs, bias or what they’re the individual’s fears are in the health care system, what type of discrimination they’re facing and how we can show up and give that best care.
Kristie Overstreet:
And doing that in a way with the model is having the on demand training, which is what I really enjoy because as providers like we never know are we going to get time at two o’clock in the morning? It’s not like we can go attend to training at nine o’clock on a Monday. So that’s what I really wanted to make available for all providers is the ability to access an on-demand training around the providers, time to be able to stop at polls that send me questions and really get involved and make it their own. And that’s what I think is most different. As well as putting transgender in binary patients at the center of care. So much of the care that I teach in the model I learned by their journey, I’m the one that was fortunate to get to walk side by side with and still today with transgender non binary patients to understand what are their barriers, what are their stories, what are they bumping against when they go see a provider? And if we got medicine, of course. But then also when they go, let’s just say they go to physical therapy. How do they handle that? Or they go to the pharmacy? How do they handle that? And they go into a hospital in ER situation, what barriers are they face? And so by listening to those helping those individuals walk through that really the basis of how the dignity model was formed and created.
Saul Marquez:
Wow, that’s awesome. So and so it through experience being with them, you know, you’re able to to find out more and empathize. And it is about empathy and being able to understand the challenges that this community is faced with. And I guess is it about not being afraid to ask? Tell us a little bit more Right. if somebody was to walk away from this podcast interview with, say, a pearl of wisdom to help better provide care to this community, what would you what would you say to them?
Kristie Overstreet:
I would say the best thing you can do is ask your patient, how can I help you better? How can I better serve you? And putting it that way helps that patient feel like, oh, wait a minute, this provider showing up, asking me what do I need? And it’s this open door that is the safe space to speak versus the provider telling the individual what they need to do, how they need to conduct themselves or what they don’t need to be doing. And I think us providers, it can be scary to have such an open question because it’s not kind of following down that treatment, planning this, this, this or the criteria for this or that. And so that can be scary. And I know so many providers are on a time crunch. You know, you’re seeing so many patients, you’re moving through the system. You’ve got demands with EMR’s and everything going on. So just open in that question by saying, what can I do? How can I better serve you? That patient if they’re feeling comfortable with you, they’re going to tell you everything you need to know. And if you’ve got a concern about something and relating to who they are and you want to know, doing a way that’s professional and caring and affirming and not in a way that’s going to shut them down or avoid some of the question.
Saul Marquez:
You know, and as you mentioned, that it just I think about it, Dr. Kristie. It’s just like one of those things where you’re like, well, wouldn’t this make sense for all patients?
Kristie Overstreet:
Yes,
Saul Marquez:
We’re all different, you know? And so I love that you’re that you led with that tip. And, yes, let’s apply that to the LGBTQIA community. Yeah. Why don’t all your patients?
Kristie Overstreet:
Your spot on Saul. Let me give you a little example and something different to say somebody. So let’s say you have a patient walking down the hallway, going into a room or going to another room, for example, whatever is going on. And let’s say a nurse or a provider walks by and. Just to make it easy, let’s just say a transgender male, someone who was assigned female at birth but sees some sense of themselves as a. If that nurse walks by that physician walking by, that nurse kind of rolls her eyes or makes a little noise from that person’s walking. That individual can internalize that and say, oh, is that about me? Was that about me? Right. because they’re more aware of what’s going on around there where maybe that nurse was frustrated about somebody else or that she’s upset something else going. It might not have anything to do with that patient, but that patient, just because of all the discrimination and barriers and stigma they’re already facing in health care, really quickly assumes that is about them. Yeah. So that’s how even some of those nonverbals can really affect patients without realizing it. Now, as this gender woman I was assigned female at birth and I’ve always identified as a female. So if I’m walking down the hallway and I see a nurse rolled their eyes or make a call for sound, I don’t know that I’m automatically going to assume that it’s me because I don’t face that type of stigma and barriers just to say that a transgender woman would. So you’re right. So that we need to apply this to everyone. However, when it comes to LGBTQIA+ specifically transgender non binary patients. There’s this whole level of stigma that they deal with in that health care setting and almost having to prove who they are because there’s this they’ve they’ve run into experiences where other providers have doubted that they’re real or that they’re not a real woman or a real man and how they’re being seen. And that’s what comes up in that relationship between provider and patient.
Saul Marquez:
Wow. You know, I never even thought about that. And sort of it just becomes like this place where you have to justify yourself and that’s not what you’re there for.
Kristie Overstreet:
Yeah. I go to get my health care needs met, my health care needs get met. I have a lot of privilege as a sister and a woman going into that. But if you take a transgender woman, she’s going, let’s just say to go get a check. If it’s diabetes she may be dealing with or blood pressure issues, she can face that provider going, oh, well, is this really an issue for you? What’s happening with your HRT? Of course. Is there a counteractions of what’s happened with the other medication? But then also is why don’t you go off the HRT? Because it’s causing possible issues with other areas. So she’s facing all these different things that I wouldn’t have to face. And it becomes a really big setback to care. And so as I’m showing up for my visit, I’m not having all this other stuff running through my head where she may be having to be valid inner self or worrying about using the wrong name around pronoun or any other type of nonverbal that maybe come up from another provider or maybe even someone in the health care setting. It might be another patient in the lobby that that person might be dealing with. But it comes up in all these ways that a lot of times we don’t realize if we’re not a part of that community.
Saul Marquez:
Yeah, yeah. Now, that’s great. And I’m glad we’re bringing awareness to that on today’s episode. How would you say your approach has improved outcomes for this community?
Kristie Overstreet:
Well, the biggest part is educating hundreds and hundreds of providers so far. So they’re going out and spreading that awareness and advocacy. We started the Dignity Model Certification program back in 2017 to certify people as being the model certified providers. And with the hundreds that we have trained, they’ve gone out and taking care of patients and given that dignity care in the medical behavioral health field. And that shows me that there are more people getting positively affected in that way. And the other thing that’s been really great about it is back in 2014, I started doing free support groups for people exposing their gender identity and then a separate support group for parent, partner, family, friends of transgender loved ones. So we have it in person for many years. And then in 2016 we moved it online. And so now we have it virtually and we have people all over the world that attends these three support groups each month. So doing this helps me keep a pulse on the community. What’s going on? What are the barriers, what are people facing? And I’m able to bring it back and continue to progress and increase and improve the training with providers, because along with the dignity model, certification comes monthly consul calls. And so we’re on the phone each month running through cases, talking about scenarios, seeing how we can help providers and facilities have better care, and having the virtual aspect of it for the actual patients to attend for support group from all over the world and then having providers spreading the advocacy and education, showing up, feeling confident about their care. We’ve improved a lot of lives out there because the passion behind these providers.
Saul Marquez:
That’s awesome. Yeah. So if you’re listening to this today and you want to do something about it, reach out, you know, and find a way that you can make a difference with the program that Dr. Kristie has developed. It’s on demand. It’s up to date. It’s it’s a great opportunity for you to do something. And then if you’re a patient that wants support, it sounds like there’s some great groups here. What excites you most today about the work that you do?
Kristie Overstreet:
Oh, so many things, Saul. As I said, I’m so passionate about giving this care and supporting providers and patients, but I think what I’m most excited about is what I’m seeing over the last one to two years is continue to get more and more is transgender and non binary patients. We’re empowering themselves, just putting up with discrimination and just putting up with providers that don’t care for them. They are speaking up saying, no, I’m going to find a provider that’s certified or provider that’s got good reviews or provided that I know is affirming, they don’t have to just settle for any type of care. And that’s what’s happened as well with social media, the Internet. It takes one one bad..that’s why I tell health care providers and hospital associations it takes. One bad review, one bad PR, one bad thing that happens with your care for a patient and it’s all over the world. So as as executive leadership, as providers, as associations, we can’t just stay with the status quo to say, oh, we didn’t know. So sorry, that doesn’t work anymore. And that’s what I’m most excited about, is these individuals are now advocating and feeling empowered to get the health care that they all along deserved. But the rest of the world, we just need to catch up with them and love it.
Saul Marquez:
That is exciting. And it’s about those critical moments and being ready for those moments before they even happen. Right. And so I feel like a lot of these things happen and oh, well, we made a mistake and now we have to get that training. Well, don’t wait until that mistake Right. prepare yourself to address the needs of this community. Stay ahead of it. And I think great things are ahead. So this has been great. I’ve truly, truly enjoyed our chat today, Dr. Kristy. And and so if you were to leave the listeners with the closing thought, what would that thought be? And then where can they learn more and reach out to you?
Kristie Overstreet:
I would want listeners to know that I know you want to do the right thing. You’re in the health care field because you want to serve care or give to others. You have a heart. And so I want you to think of approach in every single patient with that heart of openness and care and treating that individual patient just like you would if it was a family member or loved one being seen for medical or health care reason. Remember, the basics are we’re in this to care, love, support and help individuals feel better. And as long as you keep that at heart and work on that, you can keep add learning and advocate and people are feel free to get in touch with me on dignitymodel.com. That’s where I house all the health care, education, speaking, consulting and then also on drkristieoverstreet.com, my website. I’m happy to answer questions. You can send me an email and I’ll help you work through whatever is going on for you so that you feel more confident and competent in providing that care and love it.
Saul Marquez:
What a great opportunity. Dr. Kristie, thank you so much for what you do and for sharing it with us today. It’s been a pleasure.
Kristie Overstreet:
Thanks for having me and thank you for putting all the education to the world that you do. We appreciate you.
Saul Marquez:
Thank you.
Saul Marquez:
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