Transgender individuals face barriers to transition-related healthcare. ACOG has called for obstetrician-gynecologists to assist in the care of transgender individuals. However, little is known about the unmet need for transition-related care which could be provided by obstetrician-gynecologists, particularly outside of major metropolitan areas.METHODS:
Individuals in the University of Michigan Comprehensive Gender Services Program database were invited via mailed letters to complete an IRB-exempt voluntary, anonymous online survey about transgender health. Responses were collected from April to September 2015. Data were analyzed using descriptive statistics in STATA.RESULTS:
There were 67 respondents, with a mean age of 38 (range 19–88 years). The majority of respondents were Caucasian (91%), had at least some college education (85%), and had health insurance (92%). Respondents were 61% (n=41) natal males and 39% (n=26) natal females. Most (81%) had used gender-confirming hormones; 24% had used hormones without a prescription. The majority (92%) of those who had not used hormones planned future use. Among natal females, 23% had undergone hysterectomies and 19% oophorectomies. The majority of natal females who had not had these surgeries desired to have them in the future (hysterectomy: 80%, oophorectomy: 67%). Vaginectomy was less common (4%), but was desired by 20% of natal females.CONCLUSION:
Reliance on non-prescribed hormones, and unmet medication and surgical needs are high, even among a highly educated and insured cohort of transgender individuals. Obstetrician-gynecologists are uniquely positioned to provide transition-related care, particularly surgical interventions for female-to-male individuals, and basic hormonal management.