TREATING TRANSGENDER PATIENTS by Ranit Mishori, MD, MHS

Using Patient-Preferred Identification Terminology

Language is important when it comes to addressing and describing transgender patients. One commonly used descriptor is "male to female" (MTF) or "female to male" (FTM).

Some transgender people may prefer the terms "transgender man" (same as FTM) or "transgender woman" (same as MTF) because these terms affirm the chosen identity. Others still might prefer the term "affirmed male" or "affirmed female."

One of the key concepts when caring for transgender people is honoring the patient's preferred gender identity and using the pronouns and terminology that the patient prefers.

Transgender Identity Is Not Defined by Anatomy

A transgender patient's body may have elements, traits, or characteristics that do not conform to the patient's gender identity. It is important to realize that for transgender people, their anatomy does not define them. While some transgender people opt to have surgery so that their bodies more fully match their identities, others do not desire or cannot afford surgery.

It is also a good idea—once the patient is in the exam room—to ask the patient's preferred name and pronoun, and whether the patient feels comfortable sharing their experiences concerning gender.

Assess Social Adjustment

A discussion of social adjustment, libido, sexual behavior, and quality of life should be attempted at every visit. In general, transgender persons experience more mental health issues than the general population, so it is important to have a general discussion on mental well-being at every visit.

Violence should also enter the conversation. Transgender people are believed to be victims of violence more frequently than others—from verbal and physical abuse to murder—directly related to their gender identity. Ask about a history of verbal, emotional, or physical abuse. Ask about violence, and screen for depression, suicidal thoughts, and substance abuse.