Population Care

What sets back care for transgender patients in the exam room

Marc Zarefsky , Contributing News Writer

More than 80% of transgender people have considered suicide, and about 40% have attempted to kill themselves. With those staggering percentages, it is critical for health professionals to ensure their transgender patients are doing well—not just physically, but psychologically, according to Kameryn J. Lee, MD, MSPH, founder of The Radically Inclusive Consulting Collective in Rehoboth Beach, Delaware.

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Dr. Lee, an ob-gyn and transgender woman, is a member of the inaugural cohort of the Medical Justice in Advocacy Fellowship, which is a joint venture between the AMA and the Satcher Health Leadership Institute at Morehouse School of Medicine. She talked about the challenges that transgender patients face and how physicians can help during an episode of “AMA Moving Medicine.”



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About 1.6 million people in the U.S. who are older than 13 are transgender, according to the Centers for Disease Control and Prevention, and about 40% of the transgender population is younger than 25.

Dr. Lee said that for physicians and health professionals to better treat transgender patients, they first must understand five obstacles transgender patients usually face. These are:

  • Poor physician education.
  • Poor insurance coverage for gender-affirming medications and surgeries.
  • Violence against transgender people.
  • Political attacks.
  • Murder of transgender individuals.

Each of these challenges can be mentally taxing; combined, they can be overwhelming. When it comes to poor physician education, that is one area where Dr. Lee believes substantial improvement can be made.

There is “nothing worse than sensing a doctor's discomfort and poor confidence when you're sitting in an exam room and then having to educate the doctor about yourself,” said Dr. Lee, an AMA member. “It's a terrible feeling.”

While the onus is on individual physicians to increase their knowledge about transgender topics, Dr. Lee believes a widespread push toward improving education should start in medical school.

“That’s where the initial change needs to happen,” she said. “It should happen a little more downstream too, in terms of residency programs and board certification, but the problem really lies in getting educated early. If we're not doing that, we're more unlikely to be able to catch up later.”

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A primary component of that catch-up process involves health professionals acknowledging they need to learn more about transgender topics and challenges. The AMA Center for Health Equity has created a variety of CME modules to strengthen physicians’ knowledge to offer better support to their transgender patients.

Included in the AMA Ed Hub™ Health Equity Education Center content is a range of CME courses on topics such as LGBTQ+ health, diversity and inclusion and foundations of care for LGBTQ+ patients.

“The AMA Center for Health Equity has done an amazing job in its three years of existence,” Dr. Lee said. “Progress has been made on helping physicians understand the concepts of equity and justice.”

While the educational resources are helpful, Dr. Lee said physicians must take the initiative to learn how to better serve this growing patient population.

“Educationally, it's up to you,” she said. “The responsibility is still yours to be able to learn some of the basic things first. If you don't know—ask. We want you to be prepared to see us and see us for who we are.”

AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.