From the
PRESIDENT
Robert A. Zaring, MD, MMM
GLMS President | [email protected]
PHYSICIANS AND TRANSGENDER PATIENTS:
A New Working Relationship
I
hope everyone had the most enjoyable
holiday season, and I wish everyone the
happiest new year. The new year will
no doubt bring many challenges and
innovations to the field of medicine and
the Louisville medical community. In my
past articles, I have mentioned different
technologies that I thought would shape the
field of medicine in the future. However, not
all innovations are technologically based.
Sometimes, innovations are simply a new
way of looking at a previous issue. This
month, we celebrate the birth of Dr. Martin
Luther King Jr. and his way of fighting for
equal rights which forever changed our
country. This is an example of exceptional
ideas and brave implementation to tackle
problems that had marred the moral fabric
of our country for years. It is also how one
person, or one idea can catapult the zeitgeist
of a generation down a new path.
Today, we still fight inequalities. The old
ones still exist and others have grown in
visibility in the public forum. Through the
last several years, we have seen the battles
over allowing marriage between same sex
couples and even arguments regarding who
can use what bathroom tear apart states
like our own and North Carolina. Gender
identity issues have taken center stage and
names like Caitlyn Jenner and Jazz Jennings
of Being Jazz: My Life as a (Transgender) Teen
have stirred public discourse. Other popular
television shows such as Orange is the New
Black have featured transgender individuals
in prominent roles, and just this past election
cycle Danica Roem, a transgender woman,
was elected to the Virginia State House of
Delegates. These individuals and shows have
challenged traditional views of what it means
to be a man or a woman.
With something so personal and intimate
as how you view your own gender, it should
not be any surprise that health care would
also be affected with this rise in gender
identity awareness. The American Medical
Association, at several of its latest meetings,
has had resolutions and discussions on how
to handle classifying an individual’s gender
in the medical chart. Furthermore, there
has been more discussion and mindfulness
about the unique health problems that
transgender individuals face. Vanderbilt
University’s website lists some of these
key health problems that are particular
to transgender individuals or are more
frequently seen in this patient population.
These problems include the following: access
to health care, the effects of hormone usage,
cancer, injectable silicone, substance abuse,
depression and anxiety, sexually transmitted
diseases, alcohol, tobacco and heart disease.
On that list, one of the most disturbing to
me is access to health care. The reason I find
this so disturbing is that the lack of access
to health care has primarily been due to
negative experiences these individuals have
had with the medical community. Regardless
of how one views the political debate,
there can really be no argument that these
individuals deserve the dignity and respect
other patients receive. The patient-physician
relationship is a sacred connection that
requires the physician to hold the patient’s
information private but also to treat the
patient with compassion. It is only through
that relationship that a patient can feel free
to disclose what ails them, so the physician
can treat them appropriately. Disclosing
such personal information as your health
history with someone is already intimidating
enough, much more so if the recipient has
a judging demeanor. It is also important to
remember that this relationship must be
maintained throughout the medical team
staff, including those in the front office
scheduling appointments.
I believe that a big part of the negative
experiences which transgender individuals
may have faced in the past within the
medical community have come as we have
just not known how to handle these issues.
Therefore, education is the key. Getting back
to the importance of innovation, I certainly
believe that U of L deserves a lot of credit
for its initiative in tackling this issue. The
university has led the way, and now offers
a LGBT Health Certificate for health care
students and professionals. The certificate
provides training for successful interaction
with LGBT patients. This program is self-
directed and online or may be completed
in-person. Furthermore, the University of
Louisville School of Medicine is now serving
as a pilot for medical schools across the
country by incorporating LGBT training
into the curriculum. The training will help
medical students understand and treat the
unique issues faced by the LGBT community.
The Greek philosopher Heraclitus is
credited with the famous quote, “There
is nothing permanent except change.”
This statement has had many different
permutations throughout the years but is
still often used, because it is so true. The
way gender identity is viewed is changing
in the public forum and the medical
community must adapt to those changes so
that we can offer the best care to our patients.
Thankfully, programs like those sponsored
by the University of Louisville exist to guide
us through these transforming times.
Dr. Zaring is an anatomic and clinical patholo-
gist with Louisville Pathology Associates and
practices at Jewish Hospital.
JANUARY 2018
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