Connections: Affirming care for transgender and gender diverse communities | Summer 2019

Connections is a quarterly newsletter for primary care providers covering the latest developments and advances in medicine at OHSU. Learn about the many clinical, education and outreach resources available to you and your patients.

Explore more in the Summer 2019 issue of Connections

From the OHSU Transgender Health Program

Clinical Social Worker, Amy Penkin M.S.W., L.C.S.W.

Amy Penkin, M.S.W., L.C.S.W.

Penkin, a clinical social worker, is the program supervisor of the OHSU Transgender Health Program. She is dedicated to promoting health equity for the LGBTQ+ community and other underserved populations experiencing health disparities.

Transgender, nonbinary and gender-nonconforming individuals encounter a range of barriers to accessing primary and gender-affirming health care, demonstrated by numerous needs assessments. 

At OHSU, we have developed specialized services and resources for gender diverse communities with feedback from community members. Our Transgender Health Program is a gateway for both providers and patients to access services, to get information and answers about transgender health, and to help providers learn how to create a welcoming and inclusive environment.

Providing gender-affirming hormone therapy in primary care

For some individuals, gender-affirming hormone therapy can be the first step in their medical transition. Primary care providers can administer hormone therapy and supervise overall health. Integrating hormone therapy into primary care allows providers to maintain a comprehensive approach to care for transgender patients.

We recommend that children seeking pubertal suppression or hormone therapy see a pediatric endocrinologist and people with uncontrolled chronic conditions, such as diabetes or thyroid disease, see an adult endocrinologist before beginning hormone therapy. Many patients may benefit from establishing a relationship with a mental health provider to support them as they go through their gender transition.

When to refer

  • Patients seeking gender-affirming surgical services.
  • Patients seeking information or direction about nonmedical services, such as changing identity documents or locating a support group.
  • Clinics or practices desiring to schedule a training in transgender health topics.

Right place referrals

The Transgender Health Program is the umbrella program for gender-affirming primary care and specialty services.

OHSU does not house a single transgender clinic but instead offers a collection of primary care and specialty care clinics whose providers integrate gender-affirming medical and surgical care into their practices.

Not all transgender individuals desire surgery, but many may have questions about the range of gender-affirming care options. OHSU offers comprehensive medical and surgical options for gender diverse individuals, in addition to free monthly patient education classes on topics related to specific surgeries.

Our staff at the Transgender Health Program can help direct providers and patients to the right specialist within OHSU. We can also assist with information and referrals for mental health services, identity document changes, support groups, legal services and/or other support needs.

Creating a gender-affirming workplace

The Transgender Health Program has led more than 300 training sessions reaching nearly 8,000 health care professionals inside and outside of OHSU in the last five years.

A common theme among attendees is a true desire to create a comfortable, welcoming space but also anxiety about making a mistake that offends or hurts a patient’s feelings.

Post-training feedback data show that 83 percent of attendees reported feeling much more aware of how to be responsive and affirming to those who identify under the transgender umbrella.

Our typical training encompasses an introduction to the gender spectrum, an overview of gender transition, essential skills for creating affirming environments, and strategies for trauma-informed patient interactions, including scenarios to practice skills.

A common question is how to sensitively correct a mistake in pronoun, name, gender assumption or other unintentional oversight. Our staff can partner with your clinic or regional associations to customize training.

Contact us

The OHSU Transgender Health Program offers free information and referral to all.

To refer a patient, please use the Request for Transgender Health Services form by visiting https://www.ohsu.edu/transgender-health/providers.

You can fax your referral to 5033466854.

You may also call 5034947970 or email transhealth@ohsu.edu for more information.

The Doernbecher Gender Clinic

For children under 18 seeking pubertal suppression or gender-affirming hormone therapy, we recommend visiting a specialist in pediatric endocrinology.

Upon referral from a pediatrician or primary care provider, the OHSU Doernbecher Gender Clinic offers comprehensive care for transgender and gender diverse children and families.

The Transgender Health Program also welcomes questions about surgical care for anyone under 18 and will help connect anyone to the appropriate surgeon to evaluate requests.

Update your transgender education

Visit our classes and education page at www.ohsu.edu/transhealth for continuing medical education opportunities in transgender care.