Getting Started
Trans and gender diverse people have a range of health needs, just like everyone else. Some trans people, however, will want or need specific additional medical care, medication, and affirmative surgeries that relates specifically to how they’re seeking to affirm their gender.
This is an unusual part of healthcare, as while being trans is not a mental or physical illness, we can and do provide trans patients with medical care and access to processes and procedures that assist with gender affirmation.
It is important that we understand the different ways that trans and gender diverse people access and require health care, not only because the health needs of trans and gender diverse people may look different from that of cis people, but also because many trans people report negative experiences while accessing healthcare. For instance, 53%1 of young trans and gender diverse people in Australia reported at least one negative experience with a health professional, including transphobic comments and treatment, assault, and a blanket refusal to provide care.
Due to the discrimination experienced by trans people in health settings, it is important to not make assumptions about them, their lives, bodies, wants, needs, or experiences.
This may involve creating a trans-affirming clinical environment, having medical records which reflect people’s genders and identities, thinking about how your care can be trauma informed, and even just knowing which questions are okay to ask. This may also look like using a model like informed consent to offer gender affirming hormonal care.
Some trans people will want to start hormones of some kind, including puberty blockers, masculinising therapies, or feminising therapies, and this is a process that can be supported by any GP in NSW3, and doesn’t require specialist endocrinology, in most cases. For more information about this, read our pages on hormonal care and endocrinology.
Some trans people will want gender affirming surgeries. These include top surgery, breast implants, facial surgery, gonad-removing surgeries like hysterectomies, and genital surgery (GRS), which you can read more about at each of those links, including information on how to provide aftercare and ongoing support as a trans person’s primary healthcare professional.
Trans people will often have difficult or complex relationships to other aspects of health, too. Studies have shown that trans people generally have lower mental health1 and sexual health2 outcomes, due in no small part due to the discrimination they experience in health and other settings. Many trans people also have a complex relationship with their fertility and reproductive health, and our page on that subject explores the many ways that people might seek affirmation through their fertillity and reproductive decisions.
Most importantly, trans and gender diverse patients are people first, with identities, trauma histories, fears, hopes and goals, and the role of their health providers is to support them to know and access what is possible for them, and help them to find other options and support for what is out of reach or not possible.
It is our job not just to be first rate health providers, but also allies to the communities that trust us with their care.
References
1 Smith E, Jones T, Ward R, Dixon J, Mitchell A, Hillier L. (2014). From Blues to Rainbows: The mental health and well-being of gender diverse and transgender young people in Australia [PDF]. Melbourne: Australian Research Centre in Sex, Health and Society.
2 Callander D, Wiggins J, Rosenberg S, Cornelisse VJ, Duck-Chong E, Holt M, Pony M, Vlahakis E, MacGibbon J, Cook T. (2019). The 2018 Australian Trans and Gender Diverse Sexual Health Survey: Report of Findings [PDF]. Sydney: The Kirby Institute, UNSW Sydney.
3 Cundill P. (2020). Hormone therapy for trans and gender diverse patients in the general practice setting. Australian Journal for General Practitioners, RACGP.