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Laboratory testing made more inclusive

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Access to medical tests has been made more inclusive for the transgender community in the MidCentral district after a change to laboratory testing services.

Medlab Central, which is contracted by MidCentral DHB to provide laboratory testing, has removed computer software restrictions on gender markers for certain tests.
The laboratory’s computer system previously restricted the gender identifier on tests like cervical smears, prostate markers or pregnancy tests, creating a barrier for transgender patients who required tests that did not align with their gender marker.
Medlab Central Chief Executive Dr Cynric Temple-Camp said after a review and discussion around the issue, Medlab had rewritten components of their software to make the change and now clinicians selected the appropriate gender group on the basis of their knowledge of each patient’s personal circumstances.
“This has been successfully completed and the historical gender barriers have disappeared.”
MidCentral Clinical Services Programme Lead Steve Carey said after completing MidCentral’s Gender and Sexual Diversity at work training course, he looked into the current processes within his portfolio to see whether they enabled true inclusiveness.
“Our team identified a significant barrier to access for the LGBTIQ+ community – that testing that was sex-specific meant that those who were transitioning, or had transitioned, were presented unnecessary, and sometimes unmovable, barriers to get some necessary testing completed,” he said.
“As a result of the change, those within the gender diverse community have access to the testing that they need, when they need it, regardless of how they identify. Not only does this enable better healthcare for those individuals, but it empowers them to be a participant in their own healthcare journey.”
MidCentral Education Facilitator and Rainbow Forum member Emmett Roberts, who identifies as queer and non-binary, said the change was a significant step towards making health services accessible for trans and gender diverse communities.
While there were some workarounds for the issue, such as changing the gender marker, ordering the test and changing it back again, or a clinician placing a call to the lab, not all clinicians were familiar with the process, they said.
“Many transgender patients are uncomfortable with having their gender marker changed to something that does not reflect their gender identity – especially as for many, changing it in the first place may have been a long process.
“Cisgender patients do not have to have their gender marker changed, or require other workarounds to be able to access testing, and transgender patients should also be able to access testing without having their identity invalidated.”
Discomfort and lack of knowledge with the system, for both patients and clinicians, could prevent gender-diverse people from participating in screening services at all, Roberts said.
Mr Carey said it was believed MidCentral DHB was the first to implement such a change.
“We, at MidCentral, are an organisation that listens to our population and takes action to reduce barriers to access. We appreciate and celebrate diversity and this needs to be reflected in our practice. We are pleased to have worked closely in collaboration with the Medlab Central Team on this change and hope other DHBs will follow suit to enable their gender diverse populations the same access to needed tests.”
Roberts said one of the major challenges, except for access to health services, was the personal and structural discrimination that is faced by people who are trans and gender diverse.
“We would like to see healthcare professionals and staff within all sectors to consult with these communities to identify what information, education or changes are needed to better serve the trans and gender diverse community. We offer gender and sexual diversity training at MDHB and strive to be a workplace that celebrates diversity.”
MidCentral DHB was awarded in the 2018 Diversity Awards NZ for Positive Inclusion.

Medlab change for Rainbow Forum.jpg
(L-R) Steve Carey, Sigrid Lindbom and Dr ​Cynric Temple-Camp were all instrumental in making the changes to laboratory testing.

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