Let's Talk About Gender-affirming Care

Debra Shute, August 10, 2017

Most physicians haven't been taught how to care for transgender or non-binary patients, or even how to communicate with them. But the skills are teachable, says one expert.

Alex S. Keuroghlian, MD, MPH
Alex S. Keuroghlian, MD, MPH

While attention to transgender and non-binary issues is ramping up in our general culture, knowledge and protocols for treating these populations in the healthcare space is lagging.

Fundamentally, most physicians haven't been taught how to communicate with patients about gender identity, much less how to meet their medical needs.

For insights, HealthLeaders spoke with Alex S. Keuroghlian, MD, MPH, director of education and training programs at The Fenway Institute at Fenway Health in Boston. He is also an assistant professor of psychiatry at Harvard Medical School.

HealthLeaders: There is a lot of variation in terminology when it comes to services related to gender identity. What is the best way to describe healthcare for transgender individuals?

Keuroghlian: The term we use generally for this kind of care is gender-affirming care. So we talk about gender-affirming medical care, gender-affirming behavioral healthcare, and gender-affirming surgical care.

In terms of what that involves, there are several components, which include social affirmation, legal affirmation, psychological affirmation, medical affirmation, and surgical affirmation.

HealthLeaders: What are the questions to ask in determining a patient's gender identity?

Keuroghlian: You have to have a systematic way in which gender identity data are being collected and used accordingly by all clinicians and staff. Patients should be asked at registration or the front desk what their current gender identity is and their sex assigned at birth.

Debra Shute

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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