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 Endocrinologists are often key healthcare providers for people who
are transgender. But about a third of endocrinologists are unwilling
to care for patients who are transgender, and less than half say
they feel at least somewhat competent in providing that care, said
Dr. Michael Irwig, who surveyed the doctors at an endocrinology
meeting last year.
"There is still a big access problem," said Irwig, associate
professor of medicine at the George Washington University School of
Medicine and Health Sciences in Washington, D.C. "The fact that 30
percent won't see transgender patients wouldn’t happen with any
other diagnosis."
"Basically, nobody had really done a similar survey before," said
Irwig, who is also director of the Andrology Center at GW Medical
Faculty Associates.
He asked 80 endocrinology providers from Delaware, Maryland, North
Carolina, Virginia and Washington, D.C. to answer a 19-item survey.
About 80 percent answered the survey.
Overall, 15 percent said they were not at all comfortable discussing
gender identity, and another 34 percent said they were only slightly
comfortable discussing the subject, according to the study online
now in Endocrine Practice.
Fifty-eight percent reported being less comfortable with transgender
patients than with non-transgender patients.
Fellowship training on transgender care was uncommon, reported by
less than one-third of the doctors overall and by 58 percent of
those ages 25 to 39.
Only 41 percent of participants felt at least somewhat competent in
providing care to transgender people.
And only 63 percent said transgender patients could be seen at their
practice. Irwig said he asked participants to explain why such
patients couldn't be seen, "but a lot of them didn’t fill in that
open-ended question."
He told Reuters Health there could be a number of reasons for
doctors refusing to see transgender patients, including prejudice,
lack of understanding and not feeling competent in providing the
needed care.
More training and experience may help improve healthcare access,
said Irwig.
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The Endocrine Society is updating its 2009 guidelines for caring for
people who are transgender. The guidelines provide guidance and
legitimacy, said Dr. Josh Safer, who is working on the update.
"The guidelines are an evidence-based, thoughtful approach from the
ultimate mainstream endocrinology professional society and that is
very strong for those needing reliable sources," said Safer, of the
Boston University School of Medicine, in an email to Reuters Health.
The updated guidelines include changes to terminology, new practices
on how to care for transgender adolescents and how transgender care
fits within the larger medical community, he added in a phone
interview.
Irwig said transgender people likely know healthcare access is an
issue. To find endocrinologists who can provide culturally competent
care, he suggests that patients calling doctors' offices "ask their
staff how many transgender patients are seen in the practice,
because that will give them a good idea."
Safer said he considers it a priority to train endocrinologists in
transgender medical care. He is educating his own trainees on the
subject.
"However, this is a long process," he said.
SOURCE: http://bit.ly/1R7O9x3
Endocrine Practice 2016.
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