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Feature Article

Transgender medicine: challenges in personalising care

Sarina Lim, Veena Jayadev, Ann Conway, David Handelsman

Figures

© lightfield studios/stock.adobe.com model used for illustrative purposes only
© lightfield studios/stock.adobe.com model used for illustrative purposes only

Abstract

The demand for transgender medicine and health services is increasing rapidly. However, significant barriers to healthcare exist including stigma, discrimination and lack of medical training in transgender health care. GPs play a crucial role in overcoming these barriers to provide more personalised care for transgender people.

Key Points

  • The GP is the first point of contact for transgender people seeking medical advice.
  • A multidisciplinary team (MDT) approach is essential for optimal care of transgender people.
  • It is optimal that patients initiating gender-affirming transition should be reviewed by an MDT including an experienced mental health professional and an endocrinologist to recommend, initiate and stabilise appropriate hormonal and psychoactive treatments.
  • Once stabilised, ongoing treatment can be provided by the GP with shared-care referral back to the MDT for occasional review and for management problems.
  • Creating a welcoming environment provides the first step in increasing access to transgender care.
  • Medical and/or surgical therapy, with appropriate monitoring and guidance, aims to improve gender incongruence.
  • Preventive medicine with screening for natal organ cancer risk, cardiovascular changes and bone health are essential as part of the long-term care for transgender people.

Figures

© lightfield studios/stock.adobe.com model used for illustrative purposes only
© lightfield studios/stock.adobe.com model used for illustrative purposes only