GP promotes the ‘ABC of transgender care’

Having access to a regular GP who provides holistic, non-judgemental care is one of the cornerstones of health.
 
But for the lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) community, disproportionate barriers to healthcare exist, resulting in poorer healthcare outcomes and experiences, contributing to increased mental health issues and rates of suicide, abuse and associated stigma.
 
Conversely, when a non-stigmatised approach, including holistic understanding and using inclusive language is applied, healthcare outcomes are significantly improved.
 
The RACGP’s 2022 Curriculum and syllabus for Australian general practice, Sexual health and gender diversity module, outlines GPs’ role in supporting transgender and non-binary people.
 
‘GPs have a significant role to play in respecting and acknowledging those who are transgender and/or non-binary through the use of correct names and pronouns and providing gender-affirming healthcare,’ the curriculum states.
 
‘They also need to understand the barriers to patients … and advocate for inclusive and individually appropriate healthcare to reduce social and health inequalities experienced by gender-diverse patients.’
 
Dr Clara Tuck Meng Soo, a transgender woman and Canberra-based GP who works with LGBTQI communities and patients living with HIV/AIDS, knows firsthand these experiences and the value of appropriate care.
 
‘When transgender people have been asked about their interaction with medical and allied health providers, more than 50% would report that they’ve had negative experiences,’ she told newsGP.
 
‘That obviously makes it difficult for people to access the care they actually need.’
 
Despite these experiences, Dr Soo said there is an increasingly ‘strong movement’ to inform medical and allied health practitioners about the ‘ABC of transgender care’.
 
‘We know that there are very high rates of mental health issues with people who identify as transgender or non-binary, but we do also have increasing evidence to show that gender-affirming care does make a big difference to those experiencing mental health issues,’ Dr Soo said.
 
‘I want GPs to be aware of that, and to be aware of that need to provide non-judgmental, supportive care to their patients.’
 
As part of her mission, Dr Soo is presenting at an RACGP webinar on gender-affirming care, designed to give GPs the confidence and resources needed to properly support their transgender and/or gender-diverse patients.
 
The webinar is one of the many activities happening to mark Transgender Awareness Week, which is an opportunity to raise awareness of the issues facing Australia’s transgender and gender-diverse people, as well as celebrating the community in the lead up to Trans Day of Remembrance on 20 November.
 
Dr Soo hopes the week of activities leads to a better understanding and acceptance of transgender people and their needs – now and for the foreseeable future.
 
‘All the statistics show that there are increasing numbers of people who identify as trans and non-binary, and we think because social attitudes are changing there is greater awareness of change around gender and non-binary status,’ she said.
 
‘More people are stepping up and actually saying, “That’s who I am” and approaching doctors, psychologists, nurses, specialists, to help them realise the gender identity that they feel most comfortable with.’
 
However, according to Dr Soo, many gender-diverse people still encounter ignorance within the medical sector. She says examples range from healthcare providers not understanding what pronouns to use, to not being aware of the interventions and supports available to provide advice and referrals, and even outright hostility towards patients seeking assistance.
 
The webinar aims to help address these issues by discussing approaches supportive to an individual seeking to affirm their gender, appropriate referral pathways, as well as examples of patient-centred care.
 
‘A lot of GPs still feel that they don’t have the knowledge to provide gender-affirming care, even though technically it’s not really all that difficult,’ Dr Soo said.
 
‘One of the outcomes [of the webinar] we hope for is that people will gain greater knowledge and feel more comfortable to actually provide care and support for the patients who might come to them seeking care.
 
‘Also, to make GPs more aware of what resources that are out there to improve their knowledge base … maybe get to know some of the other GPs who are working in this area so that if they need advice and support, they know who they can go to, to help them with patients they see.’

Dr Clara Tuck Meng Soo says that providing gender-affirming care is ‘just one of a suite of interventions’ that GPs can provide for patients.
 
The RACGP curriculum highlights that an important part of providing care is to be comfortable having discussions with a wide range of people, and ‘to understand the intersectionality of overlapping forms of discrimination and marginalisation for individuals, particularly regarding ethnicity, gender and sexual orientation’.
 
‘Self-reflection and awareness by the GP on their attitude to sexual health, sexuality and gender diversity is vital,’ the curriculum states.
 
Dr Soo said although there is still a need for greater awareness, there is ‘a lot of interest out there’ among GPs who want to upskill and be able to provide the care that transgender and gender-diverse patients are coming to them for.
 
‘That makes me hopeful that we will see more GPs willing to take on patients who present to them, rather than push for specialists in this area,’ she said.
 
‘It’s something that should be part of the bread and butter of general practice. [For example,] if I get a patient whom I newly diagnose with diabetes, I just continue managing that.
 
‘I’m hopeful that as time goes on and GPs get more upskill, that they will see gender-affirming care in this kind of way as well – that it’s just one of a suite of interventions that we can provide for what the patient needs.’
 
The RACGP’s Gender affirming webinar is on Wednesday 16 November, 7.00 – 8.00 pm. Free registration is available online.
 
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gender diversity gender-affirming care holistic care LGBTQI health transgender health