Well I’m About To Find Out.

It is always an adventure finding a primary care physician and even more so if you are trans.

PCP-transgender patient relationships need improvement
Healio
By Goldhammer H, et al. Ann Fam Med. 2018;doi:10.1370/afm.2321, Shires DA, et al. Ann Fam Med. 2018;doi10.1370/afm.2298.
November 27, 2018

Although most primary care physicians surveyed said they were willing to provide routine care to transgender patients, the results still concerned researchers, according to findings recently published in Annals of Family Medicine.

A separate article in Annals of Family Medicine offered guidance for PCPs seeking to learn more about treating transgender patients.

In the study, Deirdre A. Shires, PhD, MSW, MPH, of the School of Social Work at Michigan State University, and colleagues reviewed survey responses from 140 general internists and family medicine clinicians (mean age, 39.7 years; male, 58) from a health system in the Midwest.

They found 85.7% were willing to provide routine care to transgender patients and 78.6% would provide a Pap test to a transgender male. However, multivariate analysis showed the willingness to provide routine care lowered with increasing clinician’s age (adjusted OR = 0.89, P = .019). In addition, 68.6% of respondents said they were capable of providing routine care to transgender patients, 52.1% lacked familiarity with transition care guidelines, 47.9% said they lacked training on transgender health, 37.1% said they lacked exposure to transgender patients, and 32.1% said their staff lacked knowledge on transgender care.

"While many primary care clinicians provide excellent and sensitive care to transgender individuals, mounting evidence – studies of how transgender patients experience health care – suggest that this is not always the case," Shires told Healio Family Medicine.

My PCP doctor is retiring so I had to find a new PCP doctor, the clinic gave me a list of doctors to choose from and I picked a doctor who looked around 10 years out of school rather than those who looked like they just graduated.

In my eleven years since I transitioned I have had a number of specialists and only one I have questions with. That doctor didn’t look at me during my two visits but for all the others they didn’t show any reactions with my transness. One I think was over joyed in having a trans patient she just treated me just as another other patient.

My endo is an APRN and was with the doctor who I originally saw me for my hormones so I have been a patient of her since 2004.

Shires added that her research “indicates that unwillingness [to provide care to transgender patients] is likely not about training or inexperience but may be more related to bias against transgender people.”

Yes, I agree based on the doctor who didn’t look at me during either of the office visits.

One of the commenters on the article said in part…

Openly transgender and gender nonconforming people now occupy seats in classrooms, chatrooms, board rooms and our exam rooms.

I bring this up as a segue in to talking about yesterday’s classes which were on multicultural education. I taught two classes, one an undergraduate class had about twenty students and the other a graduate class had six students.

Besides the class size there was a big difference on class participation, the undergraduate class no one asked a question, they sat there like bumps on a log while the in the graduate class we had a good discussion with the students asking probing questions and they also asked question to each other.

I don’t know if it was class size that made a difference or the maturity of the students or if it was the grad student’s job experience that made the difference.

I know in business that if I sat there without adding input to a meeting I wouldn’t be with the company that long. You learn how to add value to meetings and take part in the discussion while students fresh out of high school hasn’t learned that skill yet.