Transgender and Gender-Nonconforming Patients' Obstetrics and Gynecology Care

Abstract

INTRODUCTION: The transgender and gender-nonconforming community long has been marginalized in society. As transgender individuals become more visible, obstetrician–gynecologists should direct educational initiatives to enhancing clinical templates that ensure inclusive, competent, and sensitive health services for this population, incorporating partner, culture, and community implications. Gender-unbiased health services are necessary to eliminate real and perceived barriers to care. METHODS: A review of literature on transgender medicine on PubMed over the past 5 years was conducted. RESULTS: There is scant research on transgender patients in obstetric and gynecologic health care settings, especially outside of hormonal and surgical transition. There are few studies on barriers to quality transgender health care, fewer quantitative studies on transgender patients' experiences in health care settings, and still fewer studies dealing with cultural and interpersonal practices that can help improve experiences for the patient and health care team. One non–peer-reviewed survey reports that 24% of transgender respondents were denied equal treatment in doctor's offices or hospitals, 19% were refused treatment owing to their gender identity, 28% were verbally harassed and 2% physically attacked in a medical setting, and 28% postponed or avoided necessary medical care owing to discrimination. A “gender-equal” gynecologic template of care will be presented. CONCLUSION/IMPLICATIONS: More quantitative and qualitative studies should be performed assessing the needs of the transgender and gender-nonconforming community in obstetric and gynecologic practice. Existing statistics indicate that unacceptable bias and discrimination are occurring, making transgender patients less likely to seek care. Care templates on gender-equal patient encounters should be implemented to better address global and specific health needs in this population in a nonbiased manner.