Barriers to health care often exist for transgender or gender-diverse patients, making them less inclined to seek health care. “Many transgender patients have had a negative experience with health care providers, which prevents them from wanting to seek routine medical care,” says Allison Diamant, MD, MSHS, an internal medicine physician with UCLA Health. “The result can be inadequate diagnosis of preventable and treatable conditions.”
Dr. Diamant suggests that better health care starts by choosing a primary care provider (PCP) who has extra training to understand both your medical and emotional needs.
What makes a PCP experienced in transgender health care?
An experienced gender health provider understands the nuances of caring for transgender or gender-diverse patients. These providers seek to remove reported obstacles to care such as:
- Questions unrelated to your medical visit
- Misunderstanding by medical providers about your personal needs
- Refusal of medical care
- Forms that don’t allow you to accurately list your relationship or gender status or that have rigid, insensitive questions
Both your provider and their staff should have gender training, including:
- Being respectful of patient’s preferred pronoun or name
- Providing a welcoming and open environment
- Not making assumptions
“Within the UCLA Gender Health Program, we’ve taken important steps to remove inappropriate questions from forms, such as asking for a designation like married, single, divorced or widowed,” says Dr. Diamant. “We also don’t allow forms to have options like “he” or “she” because those designations may not meet the needs of our patients.”
UCLA Health has also retooled the electronic health record to include a sexual orientation and gender identity (SOGI) SmartForm. SOGI captures a patient’s preferred name and pronoun, so every member of their health care team can use these preferences.
Meeting the health care needs of LGBTQ+ patients
“It is problematic when preventable, easily treatable health concerns like high blood pressure or diabetes aren’t diagnosed because patients don’t feel comfortable seeing a provider,” says Dr. Diamant.
PCPs should also meet the unique health needs of sexual and gender minorities, such as helping them get behavioral health support or gender-affirming treatments like:
- Hormone therapy and management
- Gender affirmation surgery
“We also know that this population is at a higher risk for sexually transmitted infections and, in some cases, anal cancer,” says Dr. Diamant. “PCPs can identify and treat these conditions with routine screenings and health visits.”
Finding the right gender health provider
“As is true in all of health care, it is essential to find a provider with whom you can have honest, open communication,” says Dr. Diamant. “Obviously your health care is even better when that person has training in gender health, so they can appropriately address risk factors and the health needs of each individual.”
Dr. Diamant recommends reaching out to friends because word of mouth is an excellent way of knowing your provider understands your perspective and is comfortable providing treatment. Other options include identified providers within a health system who have the knowledge and experience to provide high quality medical care to transgender individuals. When you’ve found a potential provider, inquire:
- If they are comfortable and experienced in providing care to the LBGTQ population
- How much training they and their staff have had in gender health
- Whether they provide and manage gender-affirming treatments
“If you currently have a provider who isn’t comfortable talking about sexual or gender health, or if they can’t address starting or maintaining hormonal therapy, it is time to make a switch” says Dr. Diamant.
The Gender Health Program at UCLA Health provides care for individuals who are transgender or gender diverse. Our expert team of providers have extra training and routinely offer compassionate, inclusive and equitable care for LGBTQ+ patients.
