Lifelong Learning - Annals of Internal Medicine: Fresh Look Blog


Wednesday, September 11, 2019

Lifelong Learning

Several years ago, a colleague and I did a conference presentation on the care of transgender patients. Although not an expert on this topic, I read the available literature and came away with more knowledge on treating transgender patients than I had before. The audience for my presentation included mostly men—men of a type sometimes gently called “old school.” In this setting, this was a euphemism for “older men who were not trained to think about sexual orientation and gender when delivering care.” Perhaps I was skeptical about how this audience would receive my presentation, but I kept to the evidence and tried to appeal to their sense of humanity.

Patients who happen to be transgender who are refused care from a health care provider are more likely to experience suicidal ideation. That fact, presented on one of my slides during my presentation, should not rest easy with any health care provider. I am not sure if the slide had any impact on the men in the room, but I hope it motivated them to learn more. All of us in medicine always need to learn more.

For this reason, I was pleased to see the recent Annals In the Clinic article, “Care of the Transgender Patient”  (1). I viewed it as not just solid clinical guidance, but also an encouraging call to primary care providers, “You got this, we can help!” The authors state, “[w]ith appropriate knowledge, primary care clinicians can initiate and manage transgender medical interventions, including hormone therapy and other agents that affect hormone levels, with involvement of an endocrinologist if needed.”

We do need to know our limitations, but as primary care doctors, we need continuous education to provide care to our patients. This is especially true for our transgender patients as evidence emerges related to optimizing their health outcomes. I appreciate the guidance this article provides and will definitely share it with colleagues.

We got this!

  1. Safer JD, Tangpricha V. Care of the transgender patient. Ann Intern Med. 2019;171:ITC1–ITC16. doi:10.7326/AITC201907020

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