Transgender men's preferences when choosing obstetricians and gynecologists

Abstract

Background Transgender men are a marginalized population with unique health care needs. However, their usage of health services is low because of considerable discrimination. A major factor in their avoidance is patient-provider interactions. Methods This cross-sectional study included 102 transgender men who anonymously completed a 55-item questionnaire in clinic, between 10/2017 and 01/2019. In addition, 92 transgender women filled out the part about family physician’s preferences. We examined which characteristics transgender men prefer in their obstetricians/gynecologists in order to promote their usage of healthcare services. Results A small majority of the transgender men (54.1%) had no gender preference for their obstetrician/gynecologist, while 42.9% preferred a female obstetrician/gynecologist and 3.1% preferred a male obstetrician/gynecologist. Most transgender men with a same-gender preference preferred female obstetricians/gynecologists for both invasive procedures (e.g., pelvic examination, 97.4%) and non-invasive procedures (e.g., cesarean section, 60%). The reasons for preferences regarding invasive procedures were feeling comfortable, embarrassment and feeling that female obstetricians/gynecologists are gentler. Transgender men who preferred female obstetricians/gynecologists ranked ability (90.5%), sexual tolerance (92.9%) and gender identity tolerance (90.5%) as the top three desirable qualities of obstetricians/gynecologists, while the responders who did not prefer female ranked ability (94.6%), experience (92.9%) and knowledge (92.9%) as the top three qualities. Transgender men with female preferences considered female obstetricians/gynecologists to be more accepting of gender identity compared to the responders that did not prefer females (47.5% vs. 9.1%, P < .001).. Conclusion A small majority of the transgender men exhibited no gender preference when choosing an obstetrician/gynecologist, although 42.9% preferred females. The latter choice was associated with the assumption that female obstetricians/gynecologists are more tolerant towards their transgender men patients. Educating the medical staff about their special needs and establishing dedicated SGM centers staffed with high percentages of female healthcare providers are highly recommended.

Barriers and enabling factors to reproductive healthcare utilization for women in the sex trade: a qualitative study

“…The ability to create such relations was enhanced when women had an accompanying person -typically a professional or a volunteer -especially when these were continuous relationships of trust. In contrast, as previously demonstrated in relation to other marginalized population in Israel, such as transgenders, discrimination and negative experiences in encountering healthcare providers may impair future healthcare utilization [27].…”

Care of the transgender population: are the Indian gynaecology residents sufficiently trained?

“…5 A study from Israel on transgender population showed that some of the factors influencing TGP in approaching doctors include their knowledge, experience and ability to be gender tolerant. 6 It is important to know when and who should treat people with gender dysphoria and what referral system exists for the same. The management of TGP is interdisciplinary involving various medical personnel like the general practitioners, endocrinologists, gynaecologists, plastic surgeons, psychiatrists, speech therapists, urologists, dermatologists etc.…”

“…16 Many educational materials and guidance are available to help the interested residents and the same can be utilized to upgrade the curriculum in TGP care. 3,5,6 These curriculum improvements should be constantly evolving and may help the residents to be comfortable to start consultation with TGP and address their concerns confidently and competently while understanding their unique needs at every step of consultation. Conducting further research on best practices in transgender related care and reflective practice would be helpful to identify and promote lasting structural changes.…”