By Andrew M. Seaman
Obstetricians and gynecologists should create welcoming environments in their offices for transgender adolescents and should know how to care for those patients, according to the American College of Obstetricians and Gynecologists (ACOG).
"These patients are going to be in our practice and we need to know what (their) salient issues are," said Dr. Veronica Gomez-Lobo, a pediatric and adolescent gynecologist at Children's National Health System in Washington, D.C.
Obstetricians and gynecologists need to address the gynecological needs of transgender patients in a sensitive manner, said Gomez-Lobo, who was a co-author of an ACOG committee statement published December 21 in Obstetrics and Gynecology.
They also need to address these youngsters' primary care issues or have them see other doctors who can address those issues, she told Reuters Health.
People who are transgender identify as a gender different from the sex assigned at birth. The ACOG Committee on Adolescent Health Care says it's unknown how many people around the world are transgender.
"We’ve been seeing a lot of these kids," Gomez-Lobo told Reuters Health. "We felt it was very important for general obstetrician-gynecologists to know about (them)."
While ACOG recommends that doctors understand gender identity and be able to treat or refer patients to appropriate care, the statement acknowledges there are still large gaps in doctors' training, knowledge and comfort in this area.
The committee points out that young males who are transgender (female to male) still have a uterus, ovaries and breast tissues. They may experience medical complications specific to those organs and may also become pregnant.
Doctors need to know about the hormones used to treat transgender patients, in order to have discussions about preserving fertility and what changes may be permanent.
The committee says it's also important for doctors to understand the social and mental health needs of transgender teens. This group of kids reports the highest rates of sexual harassment; many drop out of school due to bullying.
Among the ways doctors can create a welcoming environment for transgender adolescents are to use gender-neutral terms on forms, train staff members and make brochures on sexual minorities available, according to ACOG.
“The essential components of our role as health care providers do not change because an adolescent patient is transgender," Gomez-Lobo said in a press release. "Care should always include education about their bodies, deliberate and thoughtful assessment of symptoms or concerns, and preventive care services, like screenings and contraception. We are simply adding more nuanced cultural and medical understanding to those practices.”
Patients should feel free to bring up their gender identity to their obstetricians-gynecologists, Gomex-Lobo told Reuters Health.
"I just think that’s who should be the resource," she said.