HealthDay News — A guide to help clinicians understand the medical issues relevant to transgender persons, based on a review of current evidence, was published online July 2 in the Annals of Internal Medicine.

Joshua D. Safer, M.D., from the Mount Sinai Health System in New York City, and Vin Tangpricha, M.D., Ph.D., from the Emory University School of Medicine in Atlanta, reviewed the specific medical issues relevant to transgender persons, whose gender identity differs from their sex recorded at birth.

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The authors note that the largest barrier to care is a lack of knowledgeable providers. Transgender identity can be established in the clinical setting on the basis of history alone; patients should have persistent gender incongruence as well as the capacity to make medical decisions. Clinicians should address any mental health conditions that may confound the determination. With appropriate knowledge, primary care clinicians can initiate and manage transgender medical interventions, including hormone therapy, with involvement of an endocrinologist if necessary. For patients considering transgender-specific surgeries, clinicians should have a basic understanding of the options, including the limitations, and the typical preparation required for these surgeries. Primary care providers play an important role in counseling related to gender-affirming surgeries. The electronic medical record should have the capacity to record patient-selected pronouns as well as their gender identity and organs and tissues present. A successful care environment requires staff and provider training.

“The hope is that, as education initiatives improve, providers will become more comfortable caring for gender-minority patients, who with improved access to care, will no longer always need to seek subspecialists in transgender services,” Safer said in a statement.

One author disclosed financial ties to the pharmaceutical industry.

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This article originally appeared on Medical Bag