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VIDEO: Endocrinology initiatives can improve transgender care

LAS VEGAS – Dr. Joshua D. Safer is a man on a mission. He wants to incorporate transgender medicine into medical school curricula across North America to help increase the number of specialists who can treat individuals with gender identity disorders.

"The number of endocrinologists who do this is very small," said Dr. Safer of the departments of medicine and molecular medicine and director of the endocrinology fellowship training program at Boston University. This is partly because many physicians aren’t comfortable with the topic, said Dr. Safer. Endocrinologists should recognize that "gender identity is usually fixed," and once they accept this fact, hormone treatment for transgender individuals "follows a conventional endocrinology paradigm," he said at the annual meeting of the American Association of Clinical Endocrinologists.

By his count, there may be a dozen endocrinologists in the United States who specialize in transgender medicine. Yet, some statistics suggest that 0.3% of the population has gender identity disorder, Dr. Safer noted, "and that’s not a small number – you’re talking about hundreds of thousands of people." Also, the age of Internet and social media has helped transgender individuals recognize that they’re not alone in their battle, and "many are showing up at a younger age," he added.

Several protocols are available for physicians, including one published by the Endocrine Society and another by the World Professional Association for Transgender Health (WPATH), which is one of the oldest organizations to focus on understanding and treatment of gender identity disorders. Both groups are working to create treatment paradigms that are reproducible by physicians in multiple specialties, Dr. Safer said. The American Congress of Obstetricians and Gynecologists also has a complete list of available resources.

Dr. Safer said that endocrinologists can also contact experts like him for advice. (For instance, Dr. Safer works closely with a mental health counselor who helps patients navigate their way through the changes.)

In the meantime, he continues to give talks around the nation to raise awareness and is planning on conducting studies and surveying physicians on their knowledge of the field. Transgender medicine is already incorporated into Boston University’s medical school curriculum, he said.

Dr. Safer has no relevant financial relationships with commercial interests.

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