Notes from a Lecture on Transgender Medicine

I recently had the privilege of attending a lecture by Dr. Nick Gorton, an openly transgender physician, on the topic of transgender medicine. Long story short, it was amazing.

Anybody walks into a lecture hall and starts their talk by explaining the differences between sex and gender, between gender identity and gender expression, and defines for the audience cisgender and cissexual wins my affection right away. He also gave an introductory review of the history of transgender care in the U.S. and the flawed research and politics which have stood in the way of people getting the care that they need and deserve. He made it clear in no uncertain terms that appropriate care can be a matter of life and death, and that any doctor who refuses to either care for or appropriately and promptly refer a transgender patient is a bad doctor. If you have an interest in this topic and ever get a chance to hear Dr. Gorton speak, do it.

I couldn’t possibly encompass all of the great content from this talk here and do it justice. This site has one version of the slides I saw (see the “Transgender Medicine 201″ link), and can give you an idea of the breadth of the talk and the medical issues. I will say that as Dr. Gorton reviewed the very specific clinical details of hormone therapy and adverse effect considerations, I began to have one (very specific) worry – is this the only content the med students in this room are ever going to get on this topic? The lecture was part of the larger workplace’s school of medicine LGBT week, and was a voluntary event – I was disappointed that the room was not completely packed. Although Dr. Gorton assured the audience that “You already know 90% of what you need to know (or will by the end of training!)” and noted that “100% of the medical treatments and most of the 100% of the medical treatments and most of the surgeries are used in surgeries are used in cisgender patients,” I couldn’t help wondering what would happen when those who didn’t attend or otherwise learn about these issues met their first patient for whom the covered topics were very serious concerns. For any med students or providers reading here, I’d love to know to what extent the topic of transgender medicine was covered (or not covered) in your educations.

Big, huge, enthusiastic thanks to Dr. Gorton for his work, and for taking the time to share his knowledge with us. I would like to also thank him for sharing the following list of resources:

• San Francisco Department of Public Health Transgender Clinic

• Vancouver Coastal Health Transgender Health Program (includes guidelines for transgender care with clinical protocols and patient/consumer handouts/info)
• APA Policy Statement: Transgender, Gender Identity, & Gender Expression Non-Discrimination
• Transgender Law Center (also en Español)
• Resolution 122 introduced at the American Medical Association’s 2008 meeting
• National Center for Transgender Equality
• The Sylvia Rivera Law Project

And from the presentation:

• The World Professional Association for Transgender Health (WPATH)

• Lyon-Martin Health Services (where Dr. Gorton is a provider)
• [Book] Principles of Transgender Medicine and Surgery by Randi Ettner et al, 2007. [click on the link to find it in a library; strangely, this title is in the central/general library on my campus instead of our medical library]
• The Human Rights Campaign’s Corporate Equality Index – do an advanced search to find employers who cover transgender health including hormone treatments and surgery
• There was also a reference to the Program in Human Sexuality at the University of Minnesota – here’s the link to their Transgender Health Services

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