Provision of Patient-Centered Transgender Care

The 2016 document outlines the health care needs of transgender individuals, highlighting the lack of specific research and guidelines for this population. It emphasizes the importance of culturally competent care and the role of health care providers in addressing the higher rates of mental health issues, substance abuse, STIs, heart disease, cancer, diabetes, and HIV among transgender people. The review suggests that Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) are well-positioned to provide primary care, including hormone therapy, which carries risks such as bone demineralization and cardiovascular issues for trans men, and thrombosis for trans women. The document recommends applying general population guidelines where specific evidence is lacking, including the use of spironolactone for trans women and mammography guidelines for trans women. It also advises delaying surgical treatments until after a full year of hormone therapy under the Affordable Care Act (ACA). Finally, the document calls for minor modifications in clinical settings to create a welcoming environment for transgender individuals and stresses the need for more research and education among health care providers to improve health outcomes for this underserved population.