New Series Aims to Help Close Transgender Patient Care Gap

To address barriers in transgender medical care, the ACP published an article as part of a special series titled “In the Clinic” to help primary care physicians understand medical issues specific to transgender patients.

Studies estimate that 0.6% of U.S. adults, or 1.4 million persons, are transgender.

“Barriers to accessing appropriate and culturally competent care contribute to health disparities in transgender persons, such as increased rates of certain types of cancer, substance abuse, mental health conditions, infections, and chronic diseases.,” the authors Joshua D. Safer, MD, of Mount Sinai Health System and Icahn School of Medicine, and Vin Tangpricha, MD, PhD, of Emory University School of Medicine and the Atlanta VA Medical Center, wrote.

Two major guidelines are mentioned by the authors in the special series, published in the Annals of Internal Medicine: The World Professional Association for Transgender Health’s Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People and the Endocrine Society’s Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline.

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The authors advise clinicians to watch for signs and symptoms of depression, anxiety, and suicidality due to the higher rates of these conditions within the transgender population.

“The basic idea of this practical information is that a physician can make the diagnosis of gender dysphoria with adequate experience and training and initiate and monitor hormone therapy,” Tangpricha tells Managed Healthcare Executive. 

“Treatment for people with gender dysphoria and gender non-conformity is medically necessary and should be covered under most medical benefits. Transgender and gender non-conforming people have effective medical and surgical options that shouldn't be denied because of differences in gender expression.”

There are four takeaways for healthcare executives, according to Tangpricha:

• Medical and surgical therapy is medically necessary for transgender and gender non-conforming people.

• The diagnosis of transgender and gender dysphoria is made by history alone

• Guidelines exist for hormone and surgical treatments.

• Gender affirming hormone therapy is safe when prescribed under the supervision of a physician.