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Daily Bulletin

Helping Radiologic Technologists Support Transgender Patients With Imaging Needs

Wednesday, Nov. 30, 2022


To help minimize the health disparities experienced by the transgender and gender diverse populations, Evelyn Carroll, MD, provided radiologic technologists with strategies for creating a more comfortable and inclusive environment.

In her Tuesday afternoon talk sponsored by the American Society of Radiologic Technologists, Dr. Carroll said only 33% of radiography technologist programs include content on imaging transgender people, even though one in 200 adults in the U.S. self-identify as transgender.

"The transgender population is currently about 1.4 million people," said Dr. Carroll, a breast imaging fellow at NYU Langone. "So you'll be seeing these patients in your practice."

Communication Important to Ensure Positive Imaging Room Interactions

According to a 2019 American Journal of Roentgenology survey, 71% of transgender respondents reported at least one negative encounter with an imaging facility and 32% had to instruct staff on transgender persons. Difficulties most often occurred with image-guided procedures, ultrasound and mammography.

Dr. Carroll said the first and easiest way to make transgender patients feel comfortable is by using the appropriate terminology.

"Gender identity is not the same as sexual orientation or gender expression," she explained. "Sex is assigned or designated at birth, while gender identity is an individual's innate sense of gender, which may or may not align with one's sex. Gender expression includes clothing, behavior, speech and other visible aspects of someone's gender.

"Transgender is an adjective, not a noun," she added. "It's an umbrella term for people whose gender identity and or gender expression differs from what is typically associated with the sex they were assigned at birth."

She explained that gender transition is a process in which an individual modifies their physical characteristics and expression to align with their gender identity. But not all transgender individuals transition in the same way.

"It may involve social, legal and medical steps, but it varies from person to person," she said.

Dr. Carroll said radiology departments should record the patients sex designated at birth, gender identification and preferred name and pronouns in the patient's EMR and on intake forms. "If you make a mistake, apologize briefly, correct yourself and move on," she said. "Don't belabor the point."

Imaging Appearance of Common Gender-Affirming Therapy and Surgery Results

Dr. Carroll also showed examples of imaging sequela that radiology staff can expect to see in patients undergoing gender-affirming medical and surgical interventions. She advised technologists to thoroughly explain imaging procedures to transgender patients and to avoid asking invasive questions that aren't relevant to the exam.

Other ways to create a culture of acceptance for gender-diverse individuals in the radiology department include posting a policy of non-discrimination, providing single-user restrooms and changing rooms for all genders, and offering gender chaperones for sensitive exams.

"Working together as a team," Dr. Carroll said, "radiology departments can provide a positive experience for transgender patients."

Access the presentation, "Imaging Transgender Patients: What the Radiology Technologist Needs to Know" (T6-CRT02) on demand at