Making Appropriate Referrals for Transgender Patients
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Transgender patients face a number of challenges when seeking medical care, experts say. But keeping these challenges in mind when making referrals can help patients find specialists they are comfortable with.
A recent commentary in the AMA Journal of Ethics discusses the case of Brianna, a 29-year-old transgender woman undergoing feminizing hormone therapy. She suspects that hormones are causing nausea, but is reluctant to see her hormone specialist because of the stigma she feels with the doctor and the practice.
Such stigma may prevent transgender patients from seeking care, even if their symptoms are unrelated to their transition, the authors noted. Patients may delay care until symptoms worsen. Or, they may avoid medical professionals altogether and seek advice and products from peers or the internet.
The authors added that some health professionals have outdated views on what it means to be transgender. Some aim for a "complete transition" when patients may want something else.
Barriers to care are an issue, too. Patients may not live near doctors who specialize in transgender care, or they may not have insurance that meets their needs.
With training, primary care physicians can take a larger role in transgender care, including the management of hormone therapy, the authors said. This approach could keep patients with doctors they trust.
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