ACP issues guide to help primary care doctors care for transgender patients

Photo of doctor and patient hands while discussing medical records after health examination
A new guide aims to help primary care doctors understand the medical issues relevant to caring for transgender people. (andrei_r/GettyImages)

To help primary care and family medicine physicians provide care to transgender patients, the American College of Physicians Monday published a new guide.

With an estimated 1.4 million people in the U.S. identifying as transgender, their medical care shouldn’t be limited to physicians in specialized settings, according to the guidelines published in the Annals of Internal Medicine.

The guide, called the “Care of the Transgender Patient,” aims to help clinicians understand the medical issues relevant to caring for transgender people.

“It is important that clinicians understand the medical issues specifically relevant to transgender people,” said lead author Joshua Safer, M.D., executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City.

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“The hope is that, as education initiatives improve, providers will become more comfortable caring for gender-minority patients, who with improved access to care will no longer always need to seek subspecialists in transgender services,” Safer said.

Historically, care of transgender patients has been largely limited to select facilities, according to the guide. And previous guidelines were aimed at endocrinologists, the specialists who often provide care for transgender patients.

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“Improving access to medically and culturally competent care requires involvement of primary care providers outside such specialized settings,” the authors of the guide wrote.

However, many physicians and other clinicians may lack the knowledge needed to provide sensitive and appropriate care to their transgender patients. The guide provides help with an initial evaluation, medical management, transgender-specific surgeries and ways to improve practice.

The authors said transgender patients face barriers to accessing appropriate and culturally competent care, which can lead to serious health disparities, such as increased rates of certain types of cancer, substance abuse, mental health conditions, infections and chronic diseases.