LOUISVILLE – As Caitlyn Jenner’s transition to a woman brings transgender issues to the public forefront, a national pilot program is launching here to address this population’s private struggles in the medical world.
Beginning in August, the University of Louisville School of Medicine will be the pilot site for a new curriculum by the Association of American Medical Colleges that trains future doctors on the unique health care concerns of people who are transgender, gay, lesbian, bisexual, gender non-conforming or born with differences of sex development.
On Thursday, the school hosted a panel discussion for dozens of area doctors and other health care professionals and a networking session with transgender community leaders.
“We’re being looked at to see what works and what doesn’t and to be a model for the nation,” says Faye Jones, an assistant vice president in UofL’s Office of Diversity and Inclusion. “This is a topic that has been taboo for a long time. Physicians want to provide the best care for these patients, but they may not be aware of issues and how to address someone in a culturally responsive manner.”
Sebastian Barr, 27, knows first-hand how much the medical community needs to learn. A transgender man who was assigned female at birth, Barr says he and others in the community are made to feel unwelcome the moment they walk into a doctor’s office and have to fill out medical forms asking if they are male or female. In his case, a doctor once asked him about genital surgery when he was seeking treatment for the flu. Another time, he overheard nursing staff at an urgent care center wondering aloud why he needed testosterone and referring to him using an incorrect term. He never went back.
The Institute of Medicine, the U.S. Department of Health and Human Services and other health organizations all have recently called for more education for health care providers on LGBT health. Experts say doctors are often unfamiliar with issues such as hormonal transition or gender reassignment surgery, are unsure about how to care sensitively for these patients, and may even overtly discriminate or turn people away. Research shows that health care providers also harbor unconscious biases affecting how they interact with patients from different backgrounds.
“Even the most well-intentioned (medical) students can discriminate purely by not knowing the health care needs of these individuals,” says Kristen Eckstrand, who chairs the AAMC’s Advisory Committee on Sexual Orientation, Gender Identity and Sex Development. “It makes them scared to come back into the medical system.”
Universities and their medical schools across the country have recently made strides to improve care for transgender individuals, doctors say. Vanderbilt University in Tennessee, for example, has a “Trans Buddy Program,” which provides emotional support to transgender patients during health care visits. Eckstrand says various medical schools around the nation have tried to address LGBT issues in doctor training in a non-standardized way.
But the AAMC’s new guidelines on treating these patients, released last November, were the first formal standards on the subject for medical schools and health care organizations, Eckstrand says, adding that U of L’s medical school was the first to step forward and embrace the project.
Curriculum guidelines identify 30 “competencies” doctors must master in areas such as patient care and communication and are designed to be integrated into existing curriculums to encourage people not to think of patients in these groups as separate from the overall patient population. They include real-life scenarios for students to discuss, such how to interact with a gender non-conforming child or a transgender man with a pelvic mass. Health care workers broke into small groups Thursday to discuss such scenarios.
Jones says the university will work closely with AAMC, tweaking the program as it goes and sharing their findings.
Eckstrand says Louisville is a great place for the program to launch, because it’s a relatively small city in the nation’s heartland with a diverse population, similar to many others throughout America.
“I am really proud to be the first, and I certainly don’t want to be the last,” says Brian Buford, director of UofL’s LGBT Center. “I want every school to do this. I want every person to get good care, because it can be life and death for people if it doesn’t happen.”