Breaking the Barriers to Health Care for Transgender Individuals
The latest comprehensive review addresses current practice recommendations and encourages providers to stay informed
Transgender care is swiftly evolving, and primary care providers face a greater need to be clear about their roles and when to seek the support of specialists, according to the latest review by Mount Sinai experts in the field of transgender medicine.
The new review, titled “Care of the Transgender Patient” and published July 1st in the Annals of Internal Medicine, aims to help clinicians understand the medical issues relevant to transgender people.
Joshua Safer, MD, Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery, Senior Faculty in Medicine (Endocrinology, Diabetes, and Bone Disease) at the Icahn School of Medicine at Mount Sinai, lead author of the review, and an expert in transgender health care, prepared a comprehensive review identifying the latest evidence available.
In the United States, studies estimate that 1.4 million individuals are transgender. Previous research indicates that the biggest barrier to care reported by transgender people is the lack of knowledgeable providers. The challenge of accessing culturally competent care contributes to health disparities experienced by transgender individuals, such as increased rates of cancers, substance abuse, mental health concerns, and chronic diseases.
Recommendations from the review include:
- Determining transgender identity by establishing that the patient has persistent gender incongruence
- Prescribing and managing hormone therapy with guidance from endocrinologists and awareness of the potential adverse effects of the treatment
- Understanding the various surgical options for transgender individuals with consideration of the unique post-operative concerns associated with each
- Updating electronic medical records to correctly, safely, and respectfully record relevant medical and social details for transgender individuals
- Integrating transgender medical care within relevant specialty training
“It is important that clinicians understand the medical issues specifically relevant to transgender people,” Dr. Safer explains. “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.”
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Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.