PCP-transgender patient relationships need improvement
Although most primary care physicians surveyed said they were willing to provide routine care to transgender patients, the results still concerned researchers, according to findings recently published in Annals of Family Medicine.
A separate article in Annals of Family Medicine offered guidance for PCPs seeking to learn more about treating transgender patients.
In the study, Deirdre A. Shires, PhD, MSW, MPH, of the School of Social Work at Michigan State University, and colleagues reviewed survey responses from 140 general internists and family medicine clinicians (mean age, 39.7 years; male, 58) from a health system in the Midwest.
They found 85.7% were willing to provide routine care to transgender patients and 78.6% would provide a Pap test to a transgender male. However, multivariate analysis showed the willingness to provide routine care lowered with increasing clinician’s age (adjusted OR = 0.89, P = .019). In addition, 68.6% of respondents said they were capable of providing routine care to transgender patients, 52.1% lacked familiarity with transition care guidelines, 47.9% said they lacked training on transgender health, 37.1% said they lacked exposure to transgender patients, and 32.1% said their staff lacked knowledge on transgender care.
"While many primary care clinicians provide excellent and sensitive care to transgender individuals, mounting evidence – studies of how transgender patients experience health care – suggest that this is not always the case," Shires told Healio Family Medicine.
“The results of our study are certainly concerning. First, all primary care clinicians should be willing to provide medical services that are within the scope of their practice to any patient. Just imagine if we had found that only 80% to 85% of a group of primary care clinicians were willing to provide care to cisgender women or to any other population subgroup,” she added.
Shires added that her research “indicates that unwillingness [to provide care to transgender patients] is likely not about training or inexperience but may be more related to bias against transgender people.”
The authors of the second article wrote that using the right language and communication are critical to successful relationships between PCPs and transgender patients, and the physical and emotional well-being of the latter.
They noted that gender-specific terms or identifiers, like “ma’am/sir” or “Ms./Mrs./Mr.” should be avoided in medical settings, and encouraged use of terms that apply to all genders and anatomies, such as “underwear“ and “chest.” They also wrote that registration forms that ask for “name and gender on insurance,” the “name on identification documents,” and the “name you wish to be called during the office visit” should be encouraged.
As a service to its readers, Healio Family Medicine asked clinicians from AAP, the Endocrine Society and other professional and personal backgrounds to offer perspectives on both studies and how to further improve relationships between PCPs and transgender patients. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.