OB-GYNs should know how to provide health care for transgender adolescents and create a welcoming environment for them during medical visits, according to a committee statement released on Wednesday by the American College of Obstetricians and Gynecologists (ACOG), Reuters reports.
ACOG has called on providers to be knowledgeable about gender identity and either treat or refer patients to providers able to address these needs. However, the latest statement acknowledges that many OB-GYNs still lack sufficient education, awareness and comfort in providing care for transgender patients.
ACOG said providers should know about hormone treatment for transgender patients, so they can inform patients about the effect on fertility or any permanent changes stemming from such treatment. In addition, the committee statement said OB-GYNs should be aware of transgender teenagers' social and mental health care needs. Teenagers who identify as transgender report some of the highest rates of sexual harassment, and many drop out of school because they are bullied.
In the statement, ACOG also noted that transgender male teenagers may still have a uterus, ovaries and breast tissue, which means they could experience pregnancy or other medical issues related to those organs.
The statement also outlines how OB-GYNs can create welcoming professional environments for transgender adolescent patients. For example, the committee suggests that providers use gender-neutral terms on forms, educate staff on relevant health issues and provide materials with information on sexual minorities.
Veronica Gomez-Lobo, co-author of the statement and a pediatric and adolescent gynecologist at Children's National Health System, said OB-GYNs must provide reproductive and sexual health care for transgender teenagers in a sensitive manner. She added that OB-GYNs should also be able to address transgender adolescents' primary care needs or refer them to a provider who can address those needs.
Gomez-Lobo said, "These patients are going to be in our practice and we need to know what (their) salient issues are." She said transgender adolescents should feel comfortable discussing their gender identity with their OB-GYN.
Gomez-Lobo continued, "The essential components of our role as health care providers do not change because an adolescent patient is transgender," adding, "Care should always include education about their bodies, deliberate and thoughtful assessment of symptoms or concerns, and preventive care services, like screenings and contraception. We are simply adding more nuanced cultural and medical understanding to those practices" (Seaman, Reuters, 12/21).