For the first time in three years, STFM members were able to come together at the 2022 STFM Annual Spring Conference. Attendees from all over the world converged for three days in Indianapolis, Indiana — some traveled from as far as South Africa — for workshops, general sessions, poster presentations, meetings, networking, and the STFM Foundation’s Marathonaki, and Medipalooza events.
Donations made to the STFM Foundation — large or small — create scholarships, fellowships, awards, and more, allowing the STFM Foundation to provide up-and-coming family medicine talent with training, mentoring, and scholarship opportunities. These programs would not be possible without the generosity of the members of STFM. Thank you to all who have already participated in the 20 in 2022 We Can’t Do It Without You, and we invite those who haven’t to make a donation today.
A few weeks after I met a young transgender woman in our urgent care and had offered to become her primary care doctor, she sent me an email with a link to a small study in which only 41% of endocrinologists felt competent to provide transgender care. In her email, she thanked me for being the first doctor to ask about her chosen gender pronouns and for taking the timeto learn about transgender health care.
I am a family doctor working in rural New Mexico, 2 years out of residency. I still often feel like I am working just outside my comfort zone—when I’m reducing a dislocated shoulder, managing a retained placenta, or caring for a young patient who had ingested a liquid poison. I’ve learned to rely on my colleagues, consult specialists when needed, and read—a lot. At the end of residency, I still didn’t feel comfortable with interpreting complicated EKGs, so I set up a rotation with a cardiologist and went through page after page of EKGs. I still don’t feel completely comfortable providing rheumatologic medications to patients (and my patient population has a large number with rheumatoid arthritis), so I read up and call the specialists.
Family doctors, whether working rurally or urban, are often expected to work just outside their comfort zone. I did my residency in Rhode Island and, though the nearest city with the preeminent hospital was 15 minutes away, many patients with complicated illnesses chose to continue care with us because they felt more comfortable with their family doctors, they couldn’t afford bus fare, or they were caregivers to others and wanted to stay close to home.
We, family doctors, should be at the forefront of providing medical care, including hormone therapy, to our transgender patients. We are present for our patients from birth to death, during severe medical illnesses, at moments of depression and anxiety, and also during moments of joy. It is a statement of acceptance to continue caring for our patients who are making the momentous decision to transition to a body that feels right to them.
According to the Institute of Medicine, transgender and gender nonconforming patients access health care less often than their cisgender counterparts. And when transgender patients do seek medical attention, it is often with more serious ailments.1 While many factors contribute to these disparities, health care providers can play a crucial role in reducing the stigma associated with seeing the doctor and in promoting safer health care environments for the trans members of our communities.
In fall 2015, the clinic I work at, Smiley’s Family Medicine Clinic, asked its patients who identify as transgender or gender nonconforming to speak candidly about their experiences accessing primary care. I remember scrambling to take notes as I listened to the patients’ stories and feeling grateful for the opportunity to have this small window into the challenges of seeking health care as a trans person.
Three major themes emerged from the patients’ experiences. First, small changes in language can positively impact the way a patient feels during and after an encounter with health care providers. Second, trans patients see their doctors for a number of reasons, and, like their cisgender counterparts, want to be seen as any other patient and not have their gender identity be the focus of the visit. Finally, positive partnerships occur when physicians come into the exam room as their authentic selves, who genuinely care about the patient in front of them.