Workshop Explores Issues in Transgender Health Care

Cammie Collins, a transgender woman and recent Cleveland State graduate, has endured the ridicule of her peers and frequent denial of treatment by physicians for even basic health care. During a period of 14 years, she gradually began to physically change into a female, completing her body reconstruction under the care of Cecile Unger, M.D., a Cleveland Clinic surgeon.

I had the privilege of listening to Dr. Unger and Collins speak recently at NEOMED’s transgender health workshop, the first event of the University’s annual Embracing Diversity series. After their presentations, several transgender females engaged with physicians and students in small-group discussions. Collins discussed her experience in more depth with two health care professionals, several of my peers, and me.

Growing Numbers

When two of the College of Medicine students at my table shared that they had never met a transgender person before, Collins promptly remarked that they probably had, because, “We’re everywhere.”

Even though this sexual minority is growing, Collins has encountered difficulties when it comes to finding quality health care. One of her previous insurance providers dropped her as a patient.

When Collins does find a physician who is willing to see her, she still sometimes finds a communication disconnect. At a dental exam, Collins felt obligated to inform the physician that she is transgender when she was asked the date of her last menstrual cycle. She still questions whether that question and subsequent revelation of her gender identity were truly necessary in the context of the exam.

Dr. Unger, Collins and the other participants at the transgender health workshop are pioneers in transgender health care. I admire Collins for being speaking up about weaknesses she has experienced in the health care industry. The discomfort and negative experiences she regularly endures deserve greater attention.

Training Compassionate Caregivers

I hope that health care providers of my generation will do their best to educate themselves on the background of transgender patients. One goal of professional medical education should be to train physicians and pharmacists who can ask questions that are gender-sensitive and know the nuances of treating transgendered and gender-fluid patients, versus cisgender patients (whose sexual identity corresponds to their gender at birth). These skills will be conducive to providing higher-quality health care overall.

--Katherine Wu, a first-year College of Medicine student, contributed this article.

Editor’s note: NEOMED teaches its second-year medicine students best practices for interacting with patients with a variety of gender orientations in a course called Principles of Clinical Medicine (PCM). The students conduct formal interviews with Standardized Patients (people who are trained to play the role of patients). They also interview community members who discuss their sexual health and medical issues related to their sexuality—all as part of an overall curriculum in sexual health. The PCM course teaches all aspects of the physical exam and is where students learn empathic, organized medical interviewing and clinical decision-making.

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