LGBTQ+ Pride Month: Treating Transgender Patients | Allison Asante PA-C, MBA

Allison Asante, PA-C, MBA

Pride is the annual commemoration of the Stonewall Uprising, and this year, more than ever, I’m reminded of its origins as a riot. At the midpoint of 2023, the Human Rights Campaign reports 45 anti-LGBTQIA+ laws have been enacted, over 220 bills have been introduced specifically targeting transgender and gender non-conforming people and over 540 anti-LGBTQIA+ bills have been introduced. Many of these bills directly impact transgender and gender non-conforming people’s access to healthcare and right to bodily autonomy. This pride month, we must be willing to fight on behalf of our LGBTQIA+ patients. One way to be allies and provide support is to educate ourselves on the healthcare needs of transgender and gender non-conforming patients.

The LGBTQIA+ population in the United States is growing. In a 2022 Gallup poll, 7.1% identified as LGBTQIA+, which is twice the percentage reported since 2012. In a recent Pew Research poll, 5% of people under 30 identified as transgender or gender non-conforming. As this population ages, they will also be in our offices needing treatment for gynecologic cancers. Unfortunately, like many other historically marginalized groups, these patients will often have more advanced cancers and more mistrust of the medical system.

Here are a few steps healthcare professionals can take to provide affirming care to transgender and gender non-conforming people:

1. Inquire and be supportive of a patient’s sexual orientation and gender identity during regular care.

When meeting a patient, remember not to assume they are cisgender or heterosexual. Both gender and sexual orientation are internal identities, and we must get comfortable asking about them. It is also important to ask about pronouns. I recommend putting it on yourself first; I introduce myself by saying, “Hi. My name is Allison. I use they/them pronouns. Would you mind sharing your pronouns with me?” This gives patients the option of not sharing if they don’t prefer to. Be consistent when discussing pronouns, gender identity, and sexual orientation. If you only do it for people who you think may be LGBTQIA+, you are still assuming based on appearances.

2. Collect Sexual Orientation and Gender Identity (SOGI) Data.

Much like race/ethnicity data we need to record patients’ sexual orientation and gender identity as part of their demographics. This allows us to track disparities and more simply identify the LGBTQIA+ population in data sets. Currently there are no evidence-based guidelines when it comes to the impact of medical or surgical transition on gynecologic cancer outcomes. Given the small population, evidence-based guidelines will take time, but SOGI data collection is the first step.

3. Provide trainees with culturally competent care education.

Currently, there is no requirement to include LGBTQIA+ cultural competency in any part of medical, PA, or nursing education. It has only been six years since the Association of American Medical Colleges recommended its inclusion in medical education. We must advocate within our own institutions for the inclusion of cultural competency training.

If you would like to learn more about providing LGBTQIA+ competent oncology care, please view Treating the Transgender Patient from the SGO 2023 Annual Meeting on Women’s Cancer or consider taking Welcoming Spaces, SGO’s free eight-module LGBTQ+ Cultural Humility training.

Allison Asante completed their Physician Assistant studies at Long Island University. They have been practicing as a PA for 14 years and specializing in Gynecologic Oncology for 10 years. Allison also provides queer and trans affirming gynecologic care. They recently completed their MBA in strategic healthcare administration at Hofstra University.