What you need to know about new medical guidelines for treating trans patients

One of the world’s largest medical journals has published recommendations for providing effective care to transgender patients.

Earlier this month, the American College of Physicians issued its first comprehensive guidelines on trans health, a review of related literature entitled Care of the Transgender Patient. A previous study published almost a decade ago was aimed specifically at endocrinologists (specialists to whom trans patients are often medically referred), but these new guidelines target general practitioners in an effort to improve the overall standard of care for trans patients.

Dr. Joshua Safer, executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City, is the lead author of the guidelines and says the biggest healthcare gap reported by transgender people in the United States is lack of access to knowledgeable health professionals. Last year, a small study suggested that although most physicians in the US are willing to provide routine care to trans patients, they lack the training and familiarity with guidelines to effectively care for trans individuals.

Trans people face many barriers when it comes to accessing appropriate and culturally competent care, which often leads to health disparities compared to the rest of the population. These can include increased rates of certain types of cancer, substance abuse, mental health conditions, infections and chronic illness.

“If we’re going to improve things, we need to include educating the providers who are out there,” Safer says.

Safer points out that although the current discourse surrounding trans health is often politicized, these guidelines are not. “This is the journal of a mainstream medical organization that has [both] conservative and liberal people… this is just simply standard of care.”

Care of the Transgender Patient guides a physician through various facets of care, like defining and using correct terminologies when talking about a patient’s gender identity, understanding the medical management required when it comes to hormone therapy and trans-specific surgeries as well as the legal and societal issues involved in the care of trans people.

Here are some of the key takeaways:

• Primary care physicians should be aware of all hormone therapies. They should also approach other healthcare providers for guidance when it comes to understanding the needs of trans patients; they can include qualified mental health providers and endocrinologists to help prescribe and manage hormone therapy.
• Doctors are advised to follow the guidelines for the general population when it comes to cancer surveillance and other disease prevention strategies. All relevant tissues and organs present in the patient should be tested, regardless of gender identity.
 
• Physicians should be prepared to care for patients’ pre- and post-surgeries and be familiar with the risk of complications.
• US medical societies are unied with regard to the professional obligation of physicians to provide high-quality care to transgender persons according to the current guidelines and practices. Medical records should be updated to correctly, safely and respectfully record relevant medical and social details of the patients.

Safer says, “I would argue that right now [Care of the Transgender Patient is] the best resource for primary care providers out there in terms of how complete it is and how up to date it is, and therefore I would hope that people will really rush to use it.”