Abstract
Abstract Introduction Providers will encounter transgender individuals in their practice, and it is important that they understand the unique challenges that these individuals face. Objective We sought to characterize the challenges transfeminine individuals face in seeking urological care through a developed questionnaire. Methods IRB approval was obtained to develop (with transgender community feedback) and administer a 58-item questionnaire assessing urinary and sexual health. Participants were recruited from the local community and the Philadelphia Trans Wellness Conference. We assessed the urologic care experiences of participants while comparing vaginoplasty (VP) and non-vaginoplasty (NVP) respondents. Results A total 32% of participants (n=17) sought care from a medical provider for GU/sexual symptoms in the past year. 41% of respondents (n=7) who sought medical care saw a urologist, with the majority having seen a urologist based on a referral or recommendation from another physician (n=5, 71%). Among all participants who had been to a urology practice in the past, 57% reported that they experienced a lack of knowledge about transgender health needs from a provider and/or office staff. 14 (26%) participants reported choosing not to see a urologist for one or more of the following reasons: 12 (85.7%) due to fear of being mistreated, disrespected, and/or misgendered, 10 (71.4%) due to discomfort around discussing urinary or sexual function issues as a transgender or gender nonconforming, 3 (21.4%) due to issues with insurance coverage, 3 (21.4%) due to issues with transportation or missing work, and 1 (7.14%) indicated “Other”. With respect to specific patterns of care between VP and NVP participants, we noted that NVP individuals were more likely to seek care for genitourinary issues (p=0.02) than NVP individuals. We also found that a higher proportion of VP compared to NVP individuals (45.5% vs 28.6%) sought general urologic care. Conclusions Transfeminine individuals experience a range of socio-economic barriers to urologic care. Participants indicated a reluctance to seek care because of discomfort and fear, and most reported inexperience from staff regarding transgender care. We noted that VP individuals were more likely to seek care from a urologist than NVP individuals, which may reflect a greater familiarity with the medical system. It is important for providers to be aware with these issues and communicate in a compassionate and affirming manner with their transgender patients. Disclosure No
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