In a broader outreach to physicians outside the field of endocrinology, the American College of Physicians has issued its first guidelines on the care of transgender patients.

As reported by Stat, these guidelines expand on those issued at least 10 years ago aimed primarily at endocrinologists, who were generally considered the appropriate specialty to care for transgender patients. The new guidelines instead target “your critical mass of general internal medicine people who are primary care providers and also people who are family medicine doctors,” says Dr. Joshua Safer, professor of endocrinology and executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City.

Safer adds that although it is within the scope of the practices of internal medicine and family physicians, “The biggest barrier to care reported by transgender people is lack of knowledgeable providers.”

Considering that approximately 1.4 million adults identify as transgender, the need for additional knowledgeable doctors becomes obvious—particularly when, as the report says, about a quarter of them don't look for medical help when they need it because they worry about potential discrimination from providers.

Or that they also end up being the ones to educate providers about their health care—something, according to Gillian Branstetter, spokesperson for the National Center for Transgender Equality, an advocacy group, more than half of them end up doing. Branstetter was cited praising the new guidelines that emphasize the need for primary care providers to become educated on the matter because of that very circumstance.

The guidelines also point out that, in addition to the appropriate diagnostic knowledge, the need for transgender facilities must be considered—as well as the need to train office staff to be properly trained and the need for patient medical records to be more inclusive to accommodate transgender patients.

Lest doctors think those needs don't apply to them, they might want to consider the words of Dr. Frederic Ettner, a family medicine physician in Lincolnwood, Ill., who has been seeing transgender patients for more than a decade. Says Ettner, “If you're seeing 5,000 patients in a year, knowingly or unknowingly you're going to see a couple dozen gender diverse people. You may be up to speed in rare cancers that you may not see but once in five years. You're seeing gender diverse people all the time.”

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Primary care physicians to get guidelines on transgender patients

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