Over the past year, the University of Vermont Health Network has been changing the questions that registration staff ask at the system鈥檚 six hospitals and its home health and hospice facility.
A broader age range of patients are now asked about their gender identity, and everyone 12 and older is asked their sex assigned at birth. The intent, according to the hospital system, is to improve care for the trans and nonbinary community.
But advocates in that community say they haven鈥檛 been told about the rollout of these questions. And they say that as trans and nonbinary people face risks to their safety under the current presidential administration, institutions need to be especially transparent.
What UVM Health Network is doing
UVM Medical Center Vice President of Culture, Experience and Community Health Dr. Marissa Coleman said the UVM Health Network鈥檚 updated questions about gender identity and sex assigned at birth are meant to get a better picture of the patient population in order to make care more inclusive, including using someone鈥檚 lived name, correct pronouns and gender.
鈥淲e can't treat folks with full dignity and respect if we don't know them,鈥� Coleman said. 鈥淭he ways in which gender identity was being asked was not consistent and also didn't align with .鈥�
As an example, she said hospitals in the network previously only asked about gender identity if a patient was 18 or older.
鈥淏ut we know that gender identity is something that's fluid, and oftentimes can crystallize even before the age of 18,鈥� Coleman said.
Then, in October 2024, the UVM Health Network put into effect a Biden-era , from the Centers for Medicare and Medicaid Services, and started asking people 12 and older their sex assigned at birth.
Coleman noted that this question was already under consideration for the updated registration scripts.
And while the new language made clear that patients could decline to answer, and that the reason for the question was so clinical teams could provide the most appropriate care 鈥� Coleman said the rollout of this language was 鈥渃lunky.鈥�
鈥淚 am aware that some of the language that had been used, that was not a part of our recommendations, included 鈥榯he government is requiring us to ask the question,鈥� and that's alarming,鈥� she said. 鈥淚t鈥檚 not fully accurate, and also it鈥檚 not what we would want anybody to be hearing when they鈥檙e coming into the care environment, particularly in this federal climate.鈥�
The current federal climate includes from the Trump administration and similar . In the version of the budget bill recently passed by the U.S. House, for instance, there鈥檚 a That bill is currently in the Senate.
The impact for trans, nonbinary communities
鈥淭his is a terrifying and unstable moment for so many,鈥� said Dana Kaplan, the executive director of Outright Vermont, which serves LGBTQ+ youth. 鈥淭rans youth in particular are being targeted, stripped of their ability to participate in public life, from schools to sports to medically necessary health care.鈥�
Because of this fear, Kaplan said it鈥檚 extra important for institutions to share information early and often around policies impacting trans and nonbinary people, like being asked to share their gender identity and sex assigned at birth.
鈥淲e know that for some trans young people, it will feel affirming and helpful to have that question asked, to say that 鈥榳e understand that your sex assigned at birth may be different from your gender identity,鈥欌�� he said. 鈥淔or others, for young people who are stealth, who are not out, it will be really, really dangerous.鈥�
But in the case of the UVM Health Network鈥檚 newer registration questions, Kaplan said there hasn鈥檛 been any messaging: Outright Vermont didn鈥檛 know about them until 开云体育 reached out for an interview.
Pride Center of Vermont Health and Wellness Director Kell Arbor was at one point included in UVMMC鈥檚 discussions about updating the hospital network鈥檚 registration questions, but said that was months ago.
Since then, Arbor also hasn鈥檛 seen any messaging around the gender identity and sex assigned at birth questions.
鈥淚 hope they have a plan to roll out through their partners like Outright [Vermont], to update families and let folks know what to expect,鈥� Arbor said.
Arbor and Kaplan said they appreciate the efforts UVM Health Network is making to improve care access for trans and nonbinary people, including through more thorough data collection 鈥� and recognize that it鈥檚 a big system to change.
But Kaplan said systems are already not designed for trans and nonbinary people. And that to meet that community鈥檚 needs, they have to be at the center of the process.
鈥淲e have to really understand what the clear path forward is for how safety is being guaranteed and ,鈥� he said.
How UVM Health Network will go forward
Coleman, with UVMMC, said the fear described by Kaplan is 鈥渧alid and it鈥檚 real,鈥� and that it鈥檚 also felt by herself and many staff. As far as data privacy, she said .
鈥淲e're aware that things have been changing rapidly in this climate, and so we've actually felt that that is all the more reason to have very specific, scripted language,鈥� Coleman said. 鈥淪o that the question is being asked consistently, that there is more oversight 鈥� and for lack of better word, control 鈥� in how the data is collected, because we understand the risks.鈥�
She said the hospital was committed to strengthening its partnership with Outright Vermont and the Pride Center of Vermont.
