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Transgender Men Shy Away from Annual GYN Visits

<ѻý class="mpt-content-deck">— Survey shows concerns about mistreatment, uninformed providers
MedpageToday

SAN DIEGO -- Less than 40% of transgender men attended their annual gynecologic visit, citing fear of mistreatment and uninformed providers as reasons for delaying or avoiding care, according to researchers here.

In a small survey-based study, over 80% of transgender men reported that they felt that receiving an annual physical examination was important, only 37% said they attended their annual visits, reported Lydia A. Fein, MD, of the University of Miami, and colleagues.

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Co-author Adriana Wong, a medical student in the University of Miami MD/MPH program, said at the American College of Obstetricians and Gynecologists (ACOG) annual meeting that this was an area of interest among the residents and attendings in the hospital.

"Miami has a very large transgender population, and we noticed that even though there's such a large population of transgender men, many of them are not seeking out gynecologic care," she told ѻý.

Fein's group created and distributed an anonymous Web and paper-based survey to a convenience sample of transgender men in the Miami community. There were 41 men who completed the survey. The mean age of participants was 28, but ages ranged from 18 to 58. A little over half (n=23) were Caucasian. Seventeen reported they had a high school diploma, while 11 had a college degree. More than three-quarters of these men were insured.

The large majority of participants surveyed cited the importance of other gynecologic-related care for transgender men, such as routine cancer screening (80%), annual gynecologic care (71%), and testing for sexually transmitted infections (73%).

Wong cited the importance of figuring out what types of barriers are keeping these patients from pursuing annual healthcare. The fear of "mistreatment" may play a big role. Researchers found that most of these patients (81%) reported having been to the gynecologist before, but one in five said they were mistreated by the gynecologist. They included experiences such as being condescended to by a nurse when they asked about a hysterectomy or being told "we do not treat the trans."

More than half (56%) reported avoiding or delaying gynecologic care due to gender identity concerns, such as gender dysphoria and perceived uninformed providers.

ACOG weighed in on the subject in a that urged clinicians to provide quality care to their transgender patients. But Wong cited a statistic that said only 29% of gynecologists feel comfortable caring for transgender men, which she called "pretty startling."

"We can continue to expand access to education for ob/gyns because there is a very big need for education," she said. "These are areas of improvement that gynecologists can work on."

Primary Source

American College of Obstetricians and Gynecologists

Fein LA, et al "Transgender men's experiences with and perceptions of gynecologic care" ACOG 2017; Abstract 10D.