Multidisciplinary approach to imaging for gender-affirming surgery: engaging surgeons, radiologists, and patients to ensure a positive imaging experience

Abstract

Medical imaging plays an integral role in the preoperative evaluation and postoperative management of transgender and gender diverse (TGD) patients who pursue gender-affirming surgery.Radiology department encounters can be a source of anxiety for patients of any demographic, including TGD patients. Although most imaging modalities are considered "non-invasive", certain imaging procedures and other aspects of the radiology encounter could be considered quite invasive to the TGD patient. The TGD patient may be worried that the imaging examination will have to address anatomy that they feel does not align with their gender identity, or reveal some abnormality or disheartening complication of their surgery.Simultaneously, the patient must also navigate potentially uncomfortable interactions with other patients in department waiting rooms, restrooms, and changing facilities as well as with radiology staff. As the referral source to imaging facilities, providers should advocate on behalf of their TGD patients. Referring providers should work with imaging facilities to ensure their patients will receive inclusive and affirming care and not be subject to discomfort on the part of gender identity or expression. Proactive and regular communication among radiology facilities, patients, and referring providers will ensure appropriate and sensitive care for this vulnerable population. A positive imaging experience can improve patient outcomes and the relationship between healthcare providers and the TGD community they serve.

Gender-Inclusive Fellowship Naming and Equity, Diversity, and Inclusion in Radiology: An Analysis of Radiology Department Websites in Canada and the United States

“…Furthermore, policies and procedures including asking about gender identity, names, and pronouns on intake forms, offering gender-inclusive restrooms and dressing rooms, redesigning facilities to avoid gender-connoting color schemes or signage, and publicly displaying non-discriminatory policies and reading materials can help promote a safe environment. 8,13 We believe our data will serve as a road map for institutions to take steps in creating inclusive environments in radiology for TGNB individuals. Furthermore, despite an institution being accounted for in our data as having an EDI committee or CME course, there were several instances in which this information could only be found after a prolonged and extensive search by the investigators.…”

“…Furthermore, policies and procedures including asking about gender identity, names, and pronouns on intake forms, offering gender-inclusive restrooms and dressing rooms, redesigning facilities to avoid gender-connoting color schemes or signage, and publicly displaying non-discriminatory policies and reading materials can help promote a safe environment. 8,13…”

Effects of Physical Therapy on Pelvic Floor Dysfunction Among Women; A Randomized Controlled Trial

“…PFPT may be less enjoyable but the physical therapists in our study used invasive vaginal manipulation, which required disrobing. 24 PFPT enhances strength, mobility, and posture by targeting the levator ani muscles. Perineometry was practiced by PFPT participants during each workout, whereas control group participants did so pre and post-treatment.…”

Journeying Through the Hurdles of Gender-Affirming Care Insurance: A Literature Analysis

“…The 2015 US Transgender Survey (n = 27,715) conducted by the National Center for Transgender Equality (NCTE) demonstrated that transgender individuals are 12 times more likely to attempt suicide in their lifetime compared to the US general population [22]. Individuals identifying as TGD have also described the lack of health insurance as a notable barrier to utilizing mental healthcare services [23]. Nonetheless, seeing a mental healthcare professional is often required to receive gender-affirming medical treatments such as hormone replacement or GAS.…”