Upstate medical student Jordana Gilman envisions the day when patients in physicians’ waiting rooms see these categories on the intake form: Your Gender Identity and Your Preferred Pronoun.
Gestures like that, Jordana said, will send a message to transgender patients: “We treat people like you here, you are welcome here, we will give you our best.”
That was more or less the theme of the annual Transgender Health Panel Jan. 14, hosted by Upstate’s LGBT club and co-sponsored by more than a dozen other campus groups and clubs.
Four members of the local transgender community were on the panel, along with two physicians: Harold Husovsky MD, associate professor of medicine at Upstate, and Barbara Feuerstein MD, an endocrinologist at the Joslin Diabetes Center.
“I’m encouraged by the turnout,” Dr. Husovsky told the crowd of about 75 people, mostly Upstate students, in Weiskotten Hall’s ninth-floor auditorium. “Every year we get more and more, and that’s the way it should be,” he said.
Jordana, LGBT club vice-president and a second-year medical student, said the panel was designed as an introduction to the challenges transgender patients face in the health care system, and to educate future health care professionals as they strive to provide the best possible care for patients.
Jordana credited physicians who care for the unique health needs of trans patients – “the cross hormone use, the sexual health care, and even surgery if that is what patients require,” she said. “Those doctors deserve our greatest respect and support.”
The medical profession in recent years has seen some advances in awareness, acceptance and treatment of transgender patients.
In 2013, the American Psychiatric Association formally did away with the term “gender identity disorder” to describe the incongruity transgender people feel.
“Part of removing stigma is about choosing the right words,” according to the APA. “Replacing ‘disorder’ with ‘dysphoria’ in the diagnostic label is not only more appropriate and consistent with familiar clinical sexology terminology, it also removes the connotation that the patient is ‘disordered.’”
Fifty percent of transgender patients with dysphoria try to kill themselves, Dr. Husovsky said. They are in true pain, and have higher percentage of smoking and alcohol use. If untreated, he said, “it turns out badly for some of them.”
A New York State law went into effect Jan. 20 making it illegal to discriminate against or harass people based on gender identity, transgender status or gender dysphoria.
Dr. Husovsky said he has seen 60 to 80 trans patients since 1998, and each one is a unique individual. Sexual identity is a spectrum, he said, echoing an audience member’s comment that labels are meaningless.
Dr. Feuerstein said there are trans patients of all ages, and the timing of hormone treatments can be crucial – for instance, in the case of a young female transitioning to male, halting puberty through hormone treatments can delay breast development.
Here are some observations from the members of the trans community on the panel:
“Nothing ever felt right,” said Jamie, who grew up in a “masculine” home and is transitioning from male to female. “I hated what I was. I knew it was wrong for me.”
At medical appointments, Jamie said she knows as soon as the physician walks into the exam room whether it will be a good match. She’ll tell a joke, and the right response can make all the difference. “Most of us just want to be accepted,” Jamie said.
In response to a medical student’s request for advice in treating their future transgender patients, Tyler – who transitioned to male several years ago starting at age 20 — said he has had “some awkward gynecological experiences. One doctor wouldn’t even look me in the eye. I never saw him again.”
Tyler pointed out that he’s had the benefit of a supportive family and the ability to shop around for the right physician, something that a lot of transgender people don’t have.
Josh, who’s transitioning from male to female, began hormone treatments 16 months ago and said, “It’s the best thing I’ve done. It calmed a lot of nerves.”
A parent of a transgender child said their family has been fortunate, thanks in part to an understanding pediatrician. “The longer we deal with it, the easier it gets,” the parent said. “But it’s still scary.”
Afterward, Jordana said the event was a huge success.
“I know everyone walked away having learned something,” she said. “We will carry what we learned in that room with us throughout our careers, wherever they may lead.”
The panel was co-sponsored by these Upstate student groups: Endocrine Club, AMWA, COM Class of 2018, Cross Cultural Awareness, Docs for Tots, Emergency Medicine, Integrative Medicine, Jewish Med Association, Med Students for Choice, Muslim Students Association, Ob/Gyn Club, Physicians for Human Rights, Radiology Club and the Secular Students Association.