Talking to Your Doctor About Transgender Health

Note: This article was published in Letters magazine, a publication by CAMP Rehoboth.

Coming out to your family and friends, and explaining that you are transitioning is one thing. However, coming out to your doctor is just as important.

Your doctor is your partner in your health journey. As such, it is a good idea to talk to your doctor about your sexual health and your transition. In my practice, I work with a wide population of patients, including transgender or gender non-conforming patients.

Did you know that .6 percent of the U.S. population identifies as transgender? That’s 1.4 million people.

Some of my patients have explained that throughout their lives they had a feeling of dysphoria – a state of being uneasy or feeling dissatisfied with themselves or their lives. By transitioning, they have found self-acceptance and affirmation, and they now feel they are living as they were intended.

Those who are transitioning go through many steps and may require multiple physicians or care providers to complete cross-hormone therapy, surgical procedures (gender confirming), facial feminization, breast augmentation or reduction, and the social transition. There are also those who work with patients to do voice therapy.

The relief of dysphoria is the goal of my work. I work with patients to assess their overall health and wellbeing as well as the health of their endogenous reproductive organs. Often, we test hormone levels to establish a baseline before prescribing any hormone therapy. I also have each patient complete lab work to assess any levels that may be affected by treatment.

It is also important to have a discussion about potential risks the patient may face, or concerns they might have about their transition.

Patients may also want to discuss fertility issues, such as opportunities to preserve sperm or eggs for future use.

One therapy we offer at Beebe Endocrinology is called gross hormone therapy. This therapy suppresses or blocks the biologic hormones and gradually increases the cross-sex hormone.

In addition, as your health partner, I monitor your blood tests, keep records of your hormone levels based on your desired sex, and talk to you about any preventive health measures.

When transitioning it is key to work with someone who is able to monitor all your levels, including electrolytes, lipids, and liver enzymes. It is also beneficial to work with someone you trust and someone you can talk to because often there are other health issues that also need to be discussed, including age-appropriate screenings and lifestyle choices.

Transitioning can be a long and difficult journey. However, with the right physicians and care providers, as well as friends and family, by your side, it can be a journey that affirms your true self.

Samaneh Dowlatshahi, MD, is Board Certified in Internal Medicine and Fellowship Trained in Endocrinology. She practices at Beebe Endocrinology, 1526 Savannah Road, Lewes. For more information or to make an appointment, call (302) 645-2244.