‘Trans people are just people’: GPs’ role in trans healthcare

‘We’re just people and we just want to exist in a happy space and be heard.’
 
That is according to Alex Fraser who identifies as non-binary transmasc, is the head nurse at a busy Perth general practice and is a passionate LGBTQIA+ healthcare advocate.
 
He is speaking out this Transgender Awareness Week, an annual campaign running globally from 13–19 November which aims to increase understanding about transgender people and the issues members of the community face.
 
That includes within a GPs’ consulting room.
 
In a survey asking almost 1000 trans people how healthcare professionals can better support them, their top priority was better education and training in trans health.
 
But that follows a separate survey of 516 trans people from across Australia which revealed 56% of respondents had at least one incident of trans-related discrimination when accessing healthcare.


Around 15% had experienced delayed healthcare after their health complaint was not taken seriously and 6% had been denied care.
 
This is something Alex knows all too well.
 
‘It made me not want to go to the doctors and became a really big barrier in my own head that was completely unrelated to me being trans,’ he told newsGP.
 
‘I didn’t want to go and get things like my cervical screen because I didn’t know if my doctor was going to be safe for me.
 
‘I don’t think it’s necessarily about GPs being an expert in trans health, it’s just realising that we’re people that have regular health issues as well – trans people get COPD, trans people have diabetes, trans people get PCOS, trans people have mental health struggles.’
 
While there is still a long way to go, Alex does think there have been improvements in transgender healthcare in recent years.
 
And for him, finding the right GP, and surrounding himself with supportive people, was a gamechanger.
 
‘Now I go to the doctors with no question about being trans … it’s really nice to go to the doctors and be able to talk about my other stuff, but also trans stuff, and I don’t have to explain to them my experience,’ Alex said.
 
‘I hear a lot of medical people talking about, “I’m scared that I’m going to say something wrong” or “I’m scared I’m going to be offensive”.
 
‘We know a lot about ourselves and about our medical care and trans medical health and I can see how that could come across as quite scary as a doctor when your patient knows more than you.
 
‘But trans people are just people’.
 
As Transgender Awareness Week wraps up for another year, the campaign ends with Transgender Day of Remembrance on 20 November.
 
Every year on this day, people gather to honour the memory of the transgender people whose lives have been lost in acts of anti-transgender violence.
 
As Chair of RACGP Specific Interests Transgender and Gender-Diverse Healthcare, Dr Michelle Dutton said, for GPs, best practice healthcare is about ‘remembering that being trans is just one part of who that person is’.
 
‘Yes, they’re trans, and that might mean that sometimes they have some specific healthcare needs or had particular life experiences that we need to be aware of or to be able to support them with,’ she told newsGP.
 
‘But they are also maybe parents, they may be carers for other family members, they may be people who play sport and have injured their ankle.
 
‘When I think about what we can do really well as GPs, it’s just to focus on the person in front of us and take our cues from what their needs are.’
 
For Leon Stevens, a young trans and non-binary person, his gap year in 2023 turned out to be a life-changing experience.
 
‘It gave me space to explore myself, my likes, dislikes, and gender, all of which I had been suppressing in year 12 to focus on study,’ he told newsGP.
 
Having an understanding GP has been essential to Leon’s journey, so much so that he says she even taught him a few things about being trans.
 
‘I came out as trans at the end of 2022, just after I graduated high school, and wanted to start (hormone replacement therapy) HRT right away, but she advised me to give myself time to explore my gender now that my studies were done,’ he said.
 
‘At first, I thought I’d just wait a few more months and then start testosterone, but as I took time to understand myself and try new things, such as clubbing with friends, partying, and dating apps, I discovered more and more about my gender, including the fact that I am a little bit non-binary.
 
‘I am really glad I took the time to wait, and I wouldn’t have even considered it without advice from my GP.’
 
For Leon, he says one simple thing GPs and medical centres can do to help transgender patients feel safe and welcomed into the space is to include queer-positive posters, flyers, pamphlets and flags in the waiting room and doctor’s office.
 
‘I feel safe when I see these things, and even safer when there’s also information for trans or queer people such as birth control options, HIV/AIDS management, Auslan translations of queer labels,’ he said.
 
But he also said there is a lot that needs to change to create best-practice care for the community.
 
‘The Government raising the Medicare rebate so doctors can afford to bulk bill trans patients would literally save lives,’ Leon said.
 
‘It’s been well documented that queer and transgender people are more likely to be homeless, rely on Centrelink, and have worse health outcomes.
 
‘Being able to see their GP for free would help a lot of queer and transgender people get access to the care they need.’
 
Speaking to her colleagues, Dr Dutton said helping her transgender patients has been an area of healthcare where she has been able to ‘do an enormous amount of good with relatively small things’.
 
‘It’s about educating yourself about some of those aspects of creating an inclusive practice and being open to learning a bit more,’ she said.
 
‘If someone asks you for a particular type of treatment and you don’t know much about it, just being open to finding out a bit more about it.
 
‘It is an area that is incredibly rewarding to work in, and working in this space is almost like a protective against burnout – you just see people improve so dramatically.’
 
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children and young people’s health gender-diverse health LGBTQIA+ transgender health