Michael Kleerekoper, MD, MACE, has joined the faculty at the University of Toledo Medical School where he is Professor in the Department of Internal Medicine and section chief of the Endocrinology Division. The author of numerous journal studies, Dr. Kleerekoper serves on the editorial boards for Endocrine Today, Endocrine Practice, Journal of Clinical Densitometry, Journal of Women's Health, Osteoporosis International and Calcified Tissue International. Dr. Kleerekoper is also a founding board member of the newly formed Academy of Women’s Health.

Caring for patients undergoing gender identity change

Some months ago I got a call from a psychologist asking whether I would agree to work with him regarding a patient seeking a gender identity change. Having been involved in this for a few years, albeit with only a few patients and all of whom were adults and men, I accepted the referral with the condition that the patient would continue regular visits with the psychologist.

Since I accepted that first patient, I have been asked, and accepted, to assist in the care of this group of patients by several other psychologists.

Unlike my previous experience, each of the new patients has been much younger, aged 12 to 25 years. Most of these young folks come to the clinic, the younger ones with parents or those already in college with partners. My interactions are geared predominantly towards the patient and always with the parent(s) or significant other in attendance. I make it my business to avoid enquiring why the patient wants to undergo this change, but I do provide a detailed explanation of what is in store for the patient clinically.

I am very impressed by the composure of the parents of the younger folks, all of whom have worked diligently with their son or daughter and the therapist.

I would be remiss if I didn’t acknowledge that I do not understand the “biology” behind this identity change but, to the best of my recollection, I have never brought this up with the patient.

The clinical care is straightforward and to date, I don’t think I have run afoul of patient, parent or significant other.

I am presenting this to you in the hope that I will get a lot of meaningful feedback from those of you who read these blogs.