Tuesday, April 10, 2018

Don’t You Just Love It When You Have To Teach Your Doctor?

What are you taking Estrogen for?

That is what one doctor asked me before I transitioned and was on Cross-gender Hormone Therapy (CHT). It was great that he asked but I sure wish that he learned it in medical school.
Transgender Patients: Are You Asking the Right Questions?
Spencer Miller, RN, discusses approaches and barriers
Med Page Today
By Spencer Miller, RN, Minority Nurse
April 08, 2018

How often should a man get breast and cervical cancer screenings? Should a woman get screened for prostate cancer? The answer to these questions and more depends on knowing if your patient is transgender.
When it comes to healthcare, are we ready to meet these patients' needs? Several cases where a transgender or gender-expansive person was not properly identified, or their provider simply was not aware of issues regarding transgender individuals, have been in the news lately

My county hospital is rolling out changes to our health information management system (HIMS) to try to capture this complete information on all of our patients, including transgender and gender-expansive patients. These questions are called SOGIE, which stands for Sexual Orientation, Gender Identity, and Expression. At intake, we ask:
  • What is the sex listed on your original birth certificate?
  • What is your gender identity?
  • What is your sexual orientation?
Our initial goal is to capture 10% of our patient population with rolling increases as we move forward. In the hopes of meeting all of our patients' needs, we will ask these questions just one time over the patient's lifetime. However, the patient can initiate changes at any time in the future.

Our LGBTQ patients can have health issues that are occult if we don't have correct data. A female-to-male (FTM) person with residual breast cancer did not know he needed breast cancer screenings. By the time it was diagnosed, the cancer was advanced. Another patient, male to female (MTF) did not discover her prostate cancer until it metastasized to her bones.
It is a two way street… we have to be up front with our healthcare providers.

Maybe in the emergency room when we go in for a broken wrist do we need to tell them that we are trans. But if you go in for a pain in your stomach and you are a trans man you should tell them that you are trans, it could be a matter of life or death… your death.

When I go for my annual physical this week I have a printout of my meds that I give the healthcare provider.

So where am I today?

Today and tomorrow I am at a medical college on a panel talking about LGBT health issues for second year med students.

Yes, I did time this post to be published while I’m at the university.

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