Transgender Health Resource Guide

Health Care for Transgender Individuals: Resource Guide

This guide is divided into 3 sections; 1) clinical information for providers, 2) general information on transgender issues and resources for patients/families, and 3) transgender advocacy.

The resources listed as follows are for information purposes only. Referral to these sources and web sites does not imply the endorsement of ACOG. This list is not meant to be comprehensive. The exclusion of a source or web site does not reflect the quality of that source or web site. Please note that web sites are subject to change without notice.

Clinical Information for Providers

The World Professional Association for Trangender Health (formerly known as the Harry Benjamin International Gender Dysphoria Association) is a professional organization devoted to the understanding and treatment of gender identity disorders. WPATH has approximately 350 members from around the world in fields such as psychiatry, endocrinology, surgery, psychology, sexology, counseling, sociology, and law. WPATH develops and publishes standards of care for the treatment of gender identity disorders based on evolving interdisciplinary consensus on best practice in the provision of transgender care. The Standards of Care for Gender Identity Disorders, 6th version was developed to minimize potential regrets for transsexuals following hormone therapy or genital surgery, and to present expert clinical knowledge in such treatments and procedures.

The Endocrine Society has published detailed and comprehensive clinical guidelines: The Endrocrine Treatment of Transsexual People.  This review is based on available evidence and makes recommendations on diagnostic procedures, treatment of adolescents, hormonal treatment and monitoring, screening guidelines, and sexual reassignment surgery.

The Transgender Health Program has developed clinical guidelines for transgender care that are consistent with, but more detailed than, the WPATH Standards of Care.  Their guidelines on Endocrine Therapy for Transgender Adults outlines the mechanism of action, expected effects, possible regimens, and assessments prior to and during endocrine therapy.  Other guidelines include those on Sex Reassignment surgery (SRS), Mental Health, Caring for Transgender Adolescents, and a comprehensive review of many transgender health issues, including recommendations for cancer screening, in Transgender Primary Care.

A clinical review article in the Journal of Clinical Endocrinology & Metabolism entitled Endocrine Treament of Transsexual People: A Review of Treatment Regimens, Outcomes, and Adverse Effects reviews the published literature on cross-sex hormones and presents information on transgender individuals seen in the Johns Hopkins Endocrine Clinic.  Comprehensive tables in this article describe hormone regimens in presurgical transsexual patients used at six different centers, side effects of hormonal treatment, and recommended hormonal treatment regimens and follow-up for transsexual people.

Gay and Lesbian Medical Association (GLMA)  is the largest association of lesbian, gay, bisexual and transgender (LGBT) health care professionals; its mission is to ensure equality in health care for lesbian, gay, bisexual and transgender individuals and health care providers. The Guidelines for Providing a Welcoming Environment outlines ways to make a practice more welcoming and safe for LGBT patients; this includes suggestions for taking a history (including intake forms) and discussion topics in areas of particular interest and/or possible health disparities.

The Fenway Institute (at Fenway Health in Boston, Mass.) is dedicated to advancing the skills, attitudes, and knowledge of clinicians and other health professionals by providing professional development, educational materials, and resources on LGBT health topics.  Their Learning Modules on LGBT Health are electronic slide sets created to help facilitate the teaching of LGBT health topics to clinical students, practicing clinicians, and other health professionals.  The modules can be downloaded from the website for use in courses, trainings, workshops, or for self-directed learning.  The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health is a medical textbook published by the American College of Physicians dedicated to LGBT health with chapters on transgender identity and health, and on medical and surgical management of transgender patients.

The American Academy of Pediatrics Sexual Orientation and Adolescents Clinical Report addresses the growing understanding of adolescents with differing sexual orientations.  It offers recommendations to providers in caring for non-heterosexual patients and reaffirms the practitioner’s responsibility to provide confidential, comprehensive health care and guidance in a safe and supportive environment.

For more information on Intersex Disorders (Disorders of Sex Development)

The Accord Alliance (formerly the The Intersex Society of North America) promotes comprehensive and integrated approaches to care that enhance the health and well-being of people and families affected by disorders of sex development (DSD, which includes some conditions referred to as "intersex").  The Consensus Statement on Management of Intersex Disorders is a collaborative work by fifty international experts representing important advances in thinking about appropriate care for patients and families affected by disorders of sex development. This is the document that established "disorders of sex development" as a replacement for archaic nomenclature. The Clinical Guidelines for Management of Disorders of Sex Development in Childhood provides additional information for providers.  The Accord Alliance website also includes a listing of recent PubMed articles that address issues related to disorders in sex development.

General Information on Transgender Issues and Resources for Patients/Families

The Gay and Lesbian Medical Association (GLMA) website provides an on-line guide of  Transgender Health Resources.  This includes the Ten Things Transgender Patients Should Discuss With Their Health Providers and an extensive list of health care providers who treat transgender patients, and clinics that specialize in the treatment of LGBT patients.

YouthResource is a Web site created by and for gay, lesbian, bisexual, transgender, and questioning (GLBTQ) young people. YouthResource takes a holistic approach to sexual health and exploring issues of concern to GLBTQ youth, by providing information and offer support on sexual and reproductive health issues through education and advocacy. Through monthly features, message boards, and online peer education, GLBTQ youth receive information on activism, culture, sexual health, and other issues that are important to them. A brochure on the website (available in PDF form) entitled I Think I Might Be Transgender, Now What Do I Do? addresses common questions posed by youth and their families, and also includes narrative from transgender youth to discuss these issues.  Other articles on the site include Transgender: What is it?, What is Gender Identity?, and Coming Out to Your Parents: Questions to Think About.

Trans Basics is an online educational tool created by the The Lesbian, Gay, Bisexual & Transgender Community Center. The Trans Basics site contains information about and resources for trans and gender non-conforming people and their allies, co-workers, partners, families and friends. Of particular interest is the 20 minute educational film Transgender Basics that can be viewed on this site; it outlines the concepts of gender and transgender people and transgender community members share their personal experiences of being trans.  The film targets service providers and others working with the LGBT community, but it also provides a glimpse into gender and identity for the general public.

Parents, Families, and Friends of Lesbians and Gays promotes the health and well-being of gay, lesbian, bisexual and transgender persons, their families and friends through: support, education, and advocacy.  Parents, Families and Friends of Lesbians and Gays provides opportunity for dialogue about sexual orientation and gender identity, and acts to create a society that is healthy and respectful of human diversity. Their Transgender Network focuses on support for transgender people and their parents, families, and friends, provides education on transgender facts and issues, and advocates for equal rights for the transgender community at local and national levels.

Transgender Advocacy

The National Gay and Lesbian Task Force is an organization that seeks to build the grassroots power of the lesbian, gay, bisexual and transgender (LGBT) community. They train activists, equip state and local organizations with the skills needed to organize broad-based campaigns to defeat anti-LGBT referenda and advance pro-LGBT legislation, and build the organizational capacity of the LGBT movement. Their Policy Institute provides research and policy analysis to support the effort for complete equality. As part of a broader social justice movement, they work to create a nation that respects the diversity of human expression and identity and creates opportunity for all.  Several of their publications of specific interest to the Transgender community include:  a fact sheet Scope of Explicitly Transgender-Inclusive Discrimination Laws that shows in which areas (e.g., employment, education, public accommodations) discrimination is prohibited and whether there is a private right to action; their report Lesbian, gay, bisexual and transgender youth: An epidemic of homelessness that discusses the reasons why so many LGBT youth are homeless and the risks they face in shelters and on the street; and, Opening the Door to the Inclusion of Transgender People: The Nine Keys to Making LGBT Organizations Fully Transgender-Inclusive that guides LGBT organizations through all the steps needed to make organizations fully transgender-inclusive.

The Transgender Civil Rights Project provides legislative, policy and strategy assistance, including evaluation of legislative and policy language, to activists and organizations working to pass trans-inclusive or transgender-friendly laws and policies. Although the primary work of the Project centers on nondiscrimination laws and policies, the project can provide assistance to policymakers and activists working to pass any legislation or policies regarding transgender equality. The project's primary goal is to increase the number of state, local and federal laws that prohibit discrimination based on gender identity and expression. Prohibiting discrimination based on "gender identity or expression" ensures that the entire range of transgender and gender non-conforming people are protected.

The National Center for Transgender Equality is a national social justice organization devoted to ending discrimination and violence against transgender people through education and advocacy on national issues of importance to transgender people. The Health Tab outlines the needs for change in federal policy as well as the most important trans-health priorities.

Contact:

Alicia Luchowski, MPH
Director
Health Care for Underserved Women/ LARC Program
aluchowski@acog.org