Finding healthcare providers

Finding healthcare providers that are knowledgeable and experienced in the realm of transgender and gender diverse medicine can be challenging. The vast majority of health practitioners will not have received any formal training in delivering gender affirming care. As a result, they may lack the vocabulary and understanding necessary to adequately address the needs of their transgender and gender diverse patients.

Why is this such an important issue?

Transgender and gender diverse people typically require the input of multiple healthcare providers (see below) to initiate and maintain gender affirming care. Studies show, however, that one in four transgender Australians are denied access to healthcare. Transgender individuals also report high levels of dissatisfaction with the health system.

What are the barriers contributing to substandard healthcare?

There are several barriers that contribute to the substandard healthcare of transgender and gender diverse patients, including: Inadequate education of healthcare providers, insensitive interpersonal communication, difficulty obtaining referrals, or outright refusal of care. In many instances, the patient needs to educate their healthcare provider about how to meet their needs. “Gatekeeping” is another issue, in which a healthcare provider overrides patient autonomy to control and limit access to further gender affirming treatment. Finally, lack of access in regional and rural communities often means that individuals have to travel great distances or move to a major city to receive gender affirming care.

How can I find a healthcare provider that will fulfil my needs?

It is important to engage with healthcare providers that practice in accordance with the World Professional Association for Transgender Health (WPATH) standards of care; most will also be members of the Australian and New Zealand Professional Association for Transgender Health (ANZPATH). Such healthcare providers are most suited to provide gender affirming care.

The following is a list of healthcare providers that transgender and gender diverse patients may encounter:

  1. General Practitioner (GP) – specialist medical doctor involved in all matters of health. Coordinates care by referring patients to other specialists (such as to psychiatrists, endocrinologists, etc.).

  2. Counsellor - A person trained to give guidance on personal or psychological problems.

  3. Clinical Psychologist – provide tools, techniques, and strategies to help improve one’s psychological well-being, including managing gender dysphoria, depression, and anxiety.

  4. Psychiatrist – specialist medical doctor involved in the assessment of gender dysphoria, as well as assessment and treatment of mental health concerns such as depression and anxiety. As per WPATH guidelines, assessment from a psychiatrist is necessary prior to commencing hormone therapy.

  5. Endocrinologist – specialist medical doctor involved in the assessment and treatment of hormonal and metabolic problems. Endocrinologists initiate hormone therapy after assessment by a psychiatrist and monitor its effects.

  6. Surgeon – specialist medical doctor involved in gender affirmation surgeries. Surgeons often become subspecialised to perform specific surgeries/procedures.

  7. Other healthcare providers – Nursing Staff, Sexual Health Physicians, Gynaecologists, Drug and Alcohol Services

A list of healthcare providers that practice in NSW and other Australian states that are members of ANZPATH can be found at http://www.anzpath.org/about/service-providers/