Issues to consider include how to address patients, obtaining inclusive history, unique clinical challenges
TUESDAY, Sept. 4, 2018 (HealthDay News) — Clinicians should learn how to engage with transgender patients and be prepared to manage unique clinical issues, according to a review published online Aug. 27 in JAMA Internal Medicine.
Noting that there are an estimated 1.4 million transgender adults in the United States and that this number is increasing, Nicole Rosendale, M.D., from the University of California in San Francisco, and colleagues performed a narrative review to consider issues such as how to address transgender patients, obtaining an inclusive history, and managing clinical issues.
The researchers found that in caring for a transgender patient, best practices include using a patient-identified name and pronoun, using gender-neutral terminology until the appropriate term is identified by the patient, and obtaining a surgical history that includes an anatomic inventory. Disease-specific risk factors can be modified by gender-affirming hormones, and they can confer risk for in-hospital complications and cause changes in laboratory values. Studies are limited to observational studies and case series; some of the data were derived and extrapolated from cisgender populations. Unique systems-based concerns, including lack of procedures for standardized collection of gender identity and lack of sufficiently comprehensive electronic health record platforms, were identified.
“Our goal is to provide practical skills to help clinicians feel comfortable caring for transgender patients, as well as highlight specific steps that institutions can take towards more inclusive systems of care,” a coauthor said in a statement.
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