There are several factors to consider when it comes to finding a provider who is knowledgeable about transgender health care needs and who can support transgender patients by providing high-quality gender-affirming care, primary care, or other specialty care. Dr. Maurice Garcia, transgender surgeon and director of the Cedars-Sinai Transgender Surgery and Health Program, and Dr. Sheryl Kingsberg, psychologist and chief of behavioral medicine at MacDonald Women’s Hospital/University Hospitals Cleveland Medical Center, shared tips for transgender patients in this theme.
Start with cultural competence.
At a basic level, providers and staff members in the health care center should demonstrate cultural competence. “Look for signs like using the right language,” Dr. Garcia said. “Are they asking you about your gender separate from your biological sex? Do they ask you which pronouns or name you prefer?’
About using proper language and indicating one’s own pronouns, Dr. Kingsberg said, “I think it should be self-explanatory. In addition to including their names and credentials in presentations, [some providers] they are now putting in their pronouns too, which is the slow drive towards a more self-aware healthcare environment. It’s not enough to not assume your patients’ pronouns, it’s also important to present your own.”
Those with experience working with transgender patients and/or providing gender-affirming care should be familiar with using appropriate language and demonstrating cultural competence. If you notice these things are missing, it could be a sign that the provider in question doesn’t know about transgender health care.
Explore different areas of healthcare.
Providers have different specialties, so it’s a good idea to find providers who can address different areas of care. A primary care provider can help with general health concerns, but if you’re a transitioner, you’ll need to find providers who specialize in transition-related care. This applies to both sex-affirming hormone therapy and gender-affirming surgery.
Licensed therapists, counselors or psychologists who specialize in gender identity issues can support patients as they transition or if they are experiencing any psychological distress.
“One reason a transgender person may seek psychological support is because they are distressed by the coming out process or gender confusion,” Dr. Kingsberg said. “This is not a pathology. This is very important. Being transgender is not pathological and is not why someone would need psychotherapy or therapy, and a trans-informed therapist will know that.”
Check out the World Professional Association for Transgender Health (WPATH) Standards of Care to see an international agreement on guidelines for care for transgender and gender non-conforming people;
Look for providers who are members of relevant professional organisations.
Providers who are truly committed to providing high-quality care to a specific patient group often join professional organizations related to that population so that they are up-to-date and up-to-date on the latest health care guidelines and practices. It’s usually a good sign if your provider is a member of a group like WPATH because it shows that they care about and support transgender health organizations.
Look for a gender-affirming surgeon who knows a variety of current methods.
Gender confirmation surgery, like other surgical techniques, is often updated and improved. “It would be a good idea to look for a surgeon who has experience with a variety of surgical techniques and who is up-to-date on current methods,” said Dr. Garcia.
A surgeon’s knowledge of various surgical techniques is important because gender confirmation surgery is deeply personal and therefore should be tailored to each individual’s unique needs. Dr. Garcia explained, “For example, in a traditional vaginoplasty, a vaginal canal is created, but not all patients need a vaginal canal, so patients who do not may seek a surgeon who has experience doing shallow vaginoplasty. ” (A gender confirmation surgery in which the labia and clitoris are created, but not a vaginal canal).
If possible, find a local gender-confirming surgeon.
In some cases, it may not be possible for those seeking gender-affirming surgery to find an experienced, well-qualified surgeon in their area, especially if they live in remote locations. However, whenever possible, Dr. Garcia recommends finding a local surgeon. This is important because patients are likely to need follow-up care if they develop an infection or urinary tract obstruction after surgery. With a local surgeon, it may be easier to treat these complications quickly and in a short period of time.
Finally, don’t underestimate the importance of a good bond.
Researching a provider’s credentials can only get you so far. Ultimately, if you don’t have a good relationship with your provider or don’t feel comfortable discussing your personal health needs with them, it’s probably not a good fit.
“I would encourage patients to seek out a provider with whom they have a good relationship,” Dr. Garcia said. “This is really important because patients should be able to talk to their providers about their sexual health and sexual function, especially when it comes to transgender health care. If you find that when you mention your sexual function, your provider is somewhat responsive to it, that might be fine, but if they’re not completely responsive to it, it might be time to look for a new provider.”
Of course, finding experienced, qualified providers is only part of the equation when it comes to transgender health. “Health care must go beyond medical care,” said Dr. Kingsberg. “We want to make sure that all the specific needs that a transgender person might have are met. This would certainly be mental health needs, but also social support. Since there is such a stigma for trans youth, we want to make sure that schools have adequate support. Support in the workplace is also important – ensuring HR has guidelines that protect one’s gender expression.”
Contribution to his article Maurice GarciaMD and Cheryl KingsbergPhD, IF.
Here is a list of health-related resources for transgender people:
