Family Medicine Must Meet the Needs of the LGBT Community to Build Trust

Kristine M. Diaz, PsyD

Kristine M. Diaz, PsyD

This is part of a series by the STFM Group on LGBT Health for LGBT Pride Month.

“I don’t trust my family practice doctor to treat me.”

A pre-med student who identifies as a transgender male shared this statement with me recently. I swallowed my desire to pacify him with “We are working on it.” I just listened.

It was hard to sit with the feelings that we are not doing a good job at being inclusive for all of our patients.

While we acknowledge that we are experts in serving underrepresented populations, this interaction illuminated the need for continued action. His has been one of many voices I’ve heard from the LGBT community of not trusting primary care physicians to treat LGBT individuals with compassion and relevant care.

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How Family Medicine Education Can Bolster Curriculum to Meet the Needs of the LGBT Community

This is part of a series by the STFM Group on LGBT Health for LGBT Pride Month.

By Eli Pendleton, MD; Susan Sawning, MSSW, and Stacie Steinbock, MEd

My male-to-female transgender patient is in her mid-50s. She has a well-established relationship with a sex therapist, who has written a thorough letter of explanation and support. Her wife is engaged and supports her decisions. The patient comes to me hoping to begin her hormonal transition.

Why me? I’m not an expert endocrinologist, nor do I have formal training in transgender health. However, I do have two qualities that are important to her—I’m affirming and willing. She saw an endocrinologist about the issue, but they tried to talk her out of transitioning, which left her stunned and understandably frustrated.

Here she is at my University of Louisville Family Medicine office—my fourth transgender patient looking for help with hormones. Through trial and error, countless Internet and literature searches, and frank conversations about my lack of knowledge with others who helped me find the information I needed, I now feel armed with knowledge of the proper meds to use, labs to check, questions to ask, and allies to go to for help. Today, I feel ready to help her and others who set out on this brave journey.

My hope is that out of this time-consuming and often humbling experience I, along with a core group of allies, can help make sure other family physicians and health professionals have the training they need to work expertly with this vibrant group of patients.

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