Transgender and non-binary patients often face mistreatment or marginalization when seeking health care.
In fact, a 2021 study from the Center for American Progress showed that 1 in 3 transgender patients said they have had to teach their doctors about transgender people. And, until recently, care for this population has been largely relegated to LGBTQ-focused clinics, said Laura Taylor, MD, a family medicine physician at Keck Medicine of USC.
In response to this disparity, Keck Medicine has launched a multi-department program designed to bring comprehensive, integrated and respectful care into the mainstream: the Gender-Affirming Care Program.
Gender-affirming care is health care that tends to the physical, mental and social well-being of transgender and non-binary people while respectfully affirming their gender identity, according to Taylor, who is also the program’s medical director.
While many specialists have already been treating members of the transgender and non-binary community, one of the main goals of this program is for these specialists to work in a more unified group to integrate care more effectively.
“We provide all the services that somebody may need in the course of their health care over time,” Taylor said. “That includes primary care for all medical conditions, from cradle to grave, in family medicine. Additionally, we provide supportive services for people who may be interested in gender affirming interventions like hormones, surgeries and some mental health care.”
An inclusive care spectrum
While the Gender-Affirming Care Program is multidisciplinary, Taylor encourages new patients to start their journeys with one of Keck Medicine’s family medicine doctors. This way, providers can develop trusting, long-term relationships with their patients while covering their routine and preventive health care needs.
Providers can also serve as the patient’s lead care advisor by reviewing their full health care record and advising on specialties and providers who could be helpful.
The program also works with a wide range of specialty services at Keck Medicine, including but not limited to:
- Primary care (family medicine, internal medicine)
- Plastic surgery
- Occupational therapy
- Physical therapy
- Voice training
Gender-affirming surgery is a vital component of the Keck Medicine program. Roberto Travieso, MD, the surgical director of the program, performs the full spectrum of both chest and genital surgeries (aka top and bottom surgeries), as well as facial procedures. He performed the first phalloplasty at Keck Medicine in May, 2020.
Regina Y. Baker, MD, a fellow surgeon at Keck Medicine, also offers top surgery and facial surgery. Meanwhile Leo R. Doumanian, MD, a urologist with Keck Medicine, works with Travieso on primary and revision genital surgeries and sees patients for other urological concerns. There are also multiple gynecological surgeons who perform gender-affirming hysterectomies, such as Jennifer Israel, MD.
However, both Travieso and Taylor emphasized the fact that a transgender identity does not equal a need or desire for surgery, and the program shows equal respect to whatever choice the patient feels is right for them.
The next step for the program as a whole is to hire a staff member to serve as the first point of contact for transgender and non-binary patients, as well as a source of support and guidance.
Building partnerships with the community
Travieso, Taylor and Lindsey Morrison, MHA, creator and co-chair of the Keck Pride LGBTQ+ Employee Resource Group and Committee, all share the same long-term goal for the Gender-Affirming Care Program: to provide a full range of health care services to transgender and non-binary patients and expanding access for the local population through a unified program where patients in the surrounding communities can get the integrated care they need.
Keck Medicine’s recent partnership with The TransLatin@ Coalition further highlights the value of recognizing the diverse needs among this population. This collaboration helps providers and staff at Keck Medicine run the program with guidance from patients, potential patients and their peers. The health care organization intends to develop future partnerships to take the mutual benefits of community engagement even further.
Taylor is particularly appreciative of this aspect of the program and what it will provide for caregivers and community members alike.
“We are really excited about providing high quality, equitable care to the transgender and nonbinary population and advocating for this community at Keck Medicine,” Taylor said.
— Kate Faye