What delays care for transgender patients in the exam room

More than 80% of transgender people have considered suicide and about 40% have attempted suicide. With these staggering percentages, it’s critical for healthcare professionals to make sure their transgender patients are doing well, not just physically, but psychologically, according to Kameryn J. Lee, MD, MSPH, founder of The Radically Inclusive Consulting Collective at Rehoboth Beach, Delaware.

Dr. Lee, an obstetrician and transgender woman, is part of the inaugural cohort of the Medical Justice Advocacy Fellowship, which is a joint venture between the AMA and the Satcher Health Leadership Institute at Morehouse School of Medicine. She spoke about the challenges transgender patients face and how doctors can help during a episode of “AMA Moving Medicine.”


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In the United States, about 1.6 million people over the age of 13 are transgender, according to the Centers for Disease Control and Prevention, and about 40% of the transgender population is under the age of 25.

Dr. Lee said that for doctors and healthcare professionals to better treat transgender patients, they must first understand five barriers that transgender patients commonly face. These are:

  • Poor training of doctors.
  • Poor insurance coverage for gender-affirming drugs and surgeries.
  • Violence against transgender people.
  • Political attacks.
  • Murder of transgender people.

Each of these challenges can be mentally taxing; combined, they can be overwhelming. Regarding the poor training of doctors, this is an area where Dr. Lee believes that substantial improvements can be made.

There’s “nothing worse than feeling a doctor’s discomfort and lack of confidence when you’re sitting in an exam room and then having to educate the doctor about yourself,” said Dr. Lee, member of the AMA. “It’s a terrible feeling.”

While the onus is on individual physicians to increase their knowledge of transgender topics, Dr. Lee believes a widespread push to improve education should begin in medical school.

“This is where the initial change needs to happen,” she said. “It should also happen a little further downstream, in terms of residency programs and board certification, but the problem is really in early education. If we don’t, it’s unlikely that we can catch up later. »

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A key part of this catch-up process involves healthcare professionals recognizing that they need to learn more about transgender issues and challenges. The AMA Center for Health Equity has created a variety of CME modules to build knowledge for physicians to better support their transgender patients.

Included in the AMA Ed Hub™ Center for Health Equity Education content is a range of CME courses on topics such as LGBTQ+ Health, Diversity and Inclusion and foundations of care for LGBTQ+ patients.

“The AMA Center for Health Equity has done incredible work in its three years of existence,” Dr. Lee said. “Progress has been made to help physicians understand the concepts of fairness and justice.

While educational resources are helpful, Dr. Lee said doctors need to take the initiative to learn how to better serve this growing patient population.

“Educationally, it’s up to you,” she said. “The responsibility is always yours to be able to learn some of the basics first. If you don’t know, ask. We want you to be ready to see us and see us for who we are.

AMA Moving Medicinehighlights innovation and emerging issues impacting physicians and public health today. You can see all the episodes by subscribing to the WADA’s YouTube channel or the audio-only podcast versionwhich also offers educational presentations and in-depth discussions.

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