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Health System Skimps on Trans Health Care Training

(Women) — For transgender people, it can be difficult to find a healthcare provider without a website or recommendation from a transgender peer.

“I called all endocrinologists in my area and medical network and asked if they would promote hormone replacement therapy, but most answered’no’,” said Transgender. Austin Johnson says. “I think 99 percent said no.”

Some doctors decline for moral reasons. “Some people recite the Bible,” says PhD candidate Johnson. study Transgender health Faculty of Sociology At Kent State University.

Other doctors are unfamiliar with typical transgender treatments such as hormone therapy and, as in Johnson, are reluctant to agree to provide it, so transgender men and women Keep away.

“Transgender is treated as if it were this vague and very special kind of medical system, but for me hormone therapy is exactly the same kind of hormone deficiency in men with cis. Needs monitoring. “

It speaks to a serious lack of training. Approximately 7% of the medical schools surveyed report spending zero hours of the curriculum on LGBTQ-related content during preclinical medical education. 2011 survey It was published in the Journal of the American Medical Association.

During the clinical period, the same percentage of respondents reporting zero-hour LGBT content jumped to one-third when doctor training included collaboration with real patients. Overall, the median time spent on LGBT content throughout the four years of medical school was only five hours.

“Many trans-healthcare providers are not professionals,” says Johnson. “Much of what we have found is a benevolent healthcare provider who wants to help transgender people or sees it as their vow. And what it looks like to many transgender people. Is to find a provider by word of mouth. “

When Johnson found a doctor, he helped him decide on his own treatment.

“On my first appointment, my general practitioner told me how much testosterone I was taking, how long I was using it, and whether it was typical for transgender people. I asked, “says Johnson. YouTube and Facebook were typical. “

More research

Doctor Madeline Germany Is a professor Family and community health department He is Director of Clinical Services at UCSF at the University of California, San Francisco. Center of Excellence for Transgender Health.. She recently talked about transgender health care. 2016 Women’s Health Conference Wear by Academy of Women’s Health..

Germany is demanding more research funding in trans-healthcare.

“Medicine has three components,” says German. “Medicine has medical care, education, and research. Therefore, in addition to making people available for medical care today, research is also needed.”

2014 American Journal of Public Health study If HIV-related projects were excluded, only 0.1 percent of studies funded by the National Institutes of Health determined that LGBT health was addressed.

“The transgender population makes up about 0.3-0.5% of the population, so we need at least that amount of money, but in reality we need to get more money. If there is a gap, we need more money. Because we’re going to put it in, “says Deutsch. ..

When asked what percentage of healthcare providers are trans-knowledgeable or trans-friendly, Germany replied: We know the number of orthopedic surgeons. The number of orthopedic surgeons who specialize in shoulders is probably known, but a national population-based survey on this is not sufficient. “

Transgender Jameson Emery, who lives in Greenville, South Carolina, believes more medical training will help.

“I think every healthcare professional needs to be educated about transgender issues, vocabulary, insurance and how to avoid pronouns,” says Emery.

In a recent email, he explained how to find a doctor. “All the doctors I see right now, including physicians, general practitioners, therapists, etc. South Eastern Trans Resource GuideEmery says, referring to a list of southeastern trans-friendly healthcare providers, service providers, and lawyers compiled by members of the trans community.

Concentrate on the city

Two websites, MyTransHealth When RAD reliefWas created to provide similar resources on a larger scale. However, at present, it tends to be more useful for people in big cities.

“The problem with that is that a lot of information is concentrated in metropolitan areas,” says PhD student Johnson.

“I tried to use MyTrans Health, but unfortunately there are no providers listed in my area,” says Emery.

Medical insurance is another issue.

“I have health insurance, but I don’t cover trance-related health care. I don’t cover testosterone, but thankfully, endocrinologists are happy to help.”

Kind and caring doctors can play an important role in bending the rules of groups currently outside the system. For example, some people are willing to code gender-affirming hormone therapy, such as testosterone treatment, as a general non-trans-related diagnosis to ensure insurance coverage. So, for example, we code hormone therapy as “endocrine disorders-unspecified” rather than “gender identity”.

May, Ministry of Health and Human Services added rules to the Affordable Care Act Prohibit discrimination based on race, color, country of origin, gender, age, or disability. But the spirit of correction is Section 1557Although it may be aimed at protecting transgender individuals seeking medical care, its lack of specificity can lead transgender people to be denied service in many situations.

“The official statement doesn’t think you can deny someone if you cover it for someone, so it gets complicated there,” says Johnson. Deny it for transgender people. But that means that if you don’t cover sex reassignment surgery for Sith people, you don’t have to cover surgery for trans people. However, as Johnson points out, this new fix has several advantages. “It benefits many people, including transgender men who need gynecological care and transgender women who need prostate care. It definitely helps.”

Cost-effective measures

Survey According to the 2015 Journal of General Internal Medicine, it was cost-effective to provide complete health insurance to trance individuals, taking into account the positive effects of health insurance.

Health insurance can reduce the risk of HIV, depression, substance abuse and suicide. All of these are very expensive to treat and handle. The author also estimated that providing transcoverage would cost other plan members less than 2 cents per month.

“We provide access to many other expensive medical services and keep an eye out for them,” says German. “We are doing bypass surgery, which costs hundreds of thousands of dollars, and there is no cohesive nutrition education prevention plan in this country, but we are splitting about $ 30,000 for gender-verifying care. increase.”

Johnson says the priority is to extend the reach of more mental health to transgender people.

“Number. 1 is mental health care,” says Johnson. 41 percent Transgender people try to commit suicide in their lifetime, 40% or more Experience clinical level depression and anxiety. “

Johnson believes that focusing on the mental health care of transgender people can be very helpful. “That is, rerouting resources to community groups discovered by psychologists and sociologists that peer-to-peer support is of paramount importance in improving mental health, whether it is a traditional mental health care service. Let’s do it. “

A national survey of trance-informed or trans-friendly providers will also benefit the trance population.

“”WPATH When GLMA We do this kind of thing, but these are really self-selected organizations, “says Johnson. “It’s important if non-metropolitan transgender physicians need to welcome transgender people and state or explicitly write out whether they are friendly, supportive and helpful. American Medical Association You can help it. They are a large organization with power and authority among doctors. If they lead this, I think it would be very beneficial to transgender people. “

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Written by Fem Society

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