A special thanks to the panelists and physician who inspired this article.
Recently, I was involved in a collaboration between the American Medical Women’s Association (AMWA) and the American Student Medical Association (AMSA) at my school to help our students learn more about the LGBTQIA population. To clarify, this community includes individuals identifying as lesbian, gay, bisexual, transgender, queer, intersex or asexual. We invited a board-certified OB/GYN and reproductive endocrinologist to our school, along with a few of his patients. The LGBTQIA patient population has its own unique set of challenges and understanding their struggle is vital.
Unfortunately, many members of this community have anecdotes of times in which they were disrespected, turned away, or not understood by medical professionals. One of the transgender panelist had difficulty finding a fertility physician who was willing to work with him and his wife to have him carry their child. Yes, you heard me correctly. This panelist was willing to go off testosterone in efforts to regain his menstrual cycle and carry his baby. Many physicians were unwilling to assist this couple. These stories have to be put to an end; we can do better. I hope we can challenge ourselves to be more open-minded and accepting of all those who seek our help. It’s not a physician’s job to deem what is right or wrong; rather, it is our job to serve our patients in whatever capacity we can.
Having a patient panel allowed us to hear some moving and emotional stories from these brave people. I hope other LGBTQIA members can share some of their stories with medical students around the nation because it is important for us to hear these first-hand. In addition to hearing about fertility challenges and life paths, we also heard of changes we as physicians can make to better serve this patient population. I felt the need to share these with others because I realize many students never get the chance to have an open conversation with someone who identifies as part of this community.
- On medical intake forms, leave the sex and gender fields blank so the patient can feel comfortable telling you his or her identity here, rather than only giving them two choices.
- Ask the patient what his or her preferred name is. Some patients are transitioning and may not prefer their given name.
- Ask the patient his or her preferred pronoun and make note of this. The last thing we want to do is keep referring to someone as “she” if they have never felt like a she.
- Connect with the LGBTQIA community. Unfortunately, many of these patients face discrimination. Even though it seems “sufficient” to just accept them when they come to our practice, we can do more. The patients on the panel expressed that it would be nice for physicians to reach out to their community and let them know you are welcoming to their group and want to serve them. If one of your patients happens to identify as part of this community, ask them if they can connect you to other people who may need care.
- If you have a patient who wants to transition, be sure to at least mention fertility issues. Someone transitioning may not have thought about having a family yet, but it can be very difficult to go off hormones and later become pregnant (if transitioning from female to male). In addition, the patient panelists mentioned that it would have been nice to know more about egg and sperm donation and the costs and barriers associated with those processes. Obviously we don’t need to push our patients in either direction when it comes to transitioning, because it is their choice. But it is our job to inform them and help them understand the potential issues that may arise if they do decide to transition at a younger age.
It is difficult to learn about this population because each member is different and unique. In a struggle to find medically relevant information for health care providers, I found two good resources I found for more information are from American Medical Association (AMA) and AMSA. Click the links below to find out more about the LGBTQIA population in the medical context:
Pride Flag 1 by Ant Smith