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Welcome to Healthcare Providers | FAQs

  • Q |​ How can I learn about healthcare for trans and gender-expansive people?

    ​

    You can learn about healthcare for trans and gender-expansive people using the following resources:

     

     

    Note. If you are unfamiliar with gender identity and gender-affirming care, avoid putting the burden on trans patients to explain it to you. Also, avoid certain questions about a person’s gender identity or expression, such as questions about the patient’s genitalia, that may be intrusive and irrelevant to their visit. Instead, try exploring the resources in this section to find answers first and then discuss any areas of uncertainty with your patient.

  • Q |​ How do I care for a transgender or gender-expansive person? What should I avoid doing?

    A trans or gender-expansive person may or may not pursue medical treatments or surgical procedures to affirm their gender identity. Caring for the patient means listening to their concerns and helping them make informed decisions. They also may or may not wish to disclose their gender identity to others or document it in their health records. Collecting sexual orientation and gender identity (SOGI) data is needed to ensure that data-driven treatments and approaches become available for LGBTQIA+ people; however, it is important to consult with the patient about their preferences for inclusion of their data in discussions with members of their support network or in their medical record. Be sensitive to the fact that many trans adults have rarely interfaced with the healthcare system, so they may have discomfort or feel overwhelmed in healthcare settings. Or they may distrust healthcare providers having had negative experiences in healthcare settings due to discrimination or lack of clinician knowledge of transgender health.

     

    For a patient visit, begin by sharing your name and pronouns and invite the patient to share theirs. Ask about gender identity only if it is relevant to the visit and perform only those assessments that are pertinent to the visit. Discuss the extent to which the patient’s gender identity should be kept confidential. During the visit, be direct and descriptive about the patient's diagnoses and your recommendations for their care. Be cautious about attributing patient symptoms to gender-affirming treatments and procedures that may in fact be unrelated to the symptoms (a phenomenon known as trans broken arm syndrome→).

    DO...

    DO use a patient’s pronouns and chosen name
     

    DO apologize for mistakes
     

    DO protect confidentiality
     

    DO ask, “What name do you go by?”
     

    DO ask, “What word(s) do you use to describe your gender identity?”
     

    DO ask, “What do I need to know about you to give you the best care possible?”

    DON'T...

    DON’T guess a person’s gender identity
     

    DON’T ask unnecessary or intrusive questions
     

    DON’T ask, “Are you transgender?”
     

    DON’T ask, “What is your birth name?”

    For more information on caring for trans and gender-expansive people see the National LGBTQIA+ Health Education Center or download the Gender-Affirming Care Assistance Card→ for healthcare providers.

    ​

    For a list of terms to use and terms to avoid related to gender identity see the GLAAD Media Reference Guide 11th Edition→.

  • Q |​ How do I ask a patient about their surgical history in a way that affirms their gender identity?

    ​

    Start by building rapport with the patient using the tips given above for providing care to trans and gender-expansive people. To ask about a patient’s surgical history, consider using an anatomical inventory, a checklist of organs and surgeries that is adaptable and expandable over time. Use the inventory to ask patients about their anatomy: In order to provide you with the best clinical care, it is important for me to know if you have certain body parts. Is it okay if we talk through a list of body parts, and you can let me know whether you have these? If you use different words for parts of your body, please let me know.

    __________

    Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531-2535. doi:10.1093/jamia/ocab080

  • Q |​ What are some adverse effects of hormone replacement therapy (HRT) that my patients should know about?

    ​

    Depending on the type of HRT, potential risks associated with feminizing HRT include high triglycerides, hyperkalemia, hyperprolactinemia, hypertension, weight gain, diabetes, and infertility. Long-term use of feminizing HRT in trans adults assigned male at birth may be associated with increased risk of ischemic heart disease, cerebrovascular disease, and venous thromboembolism.

     

    Potential risks associated with masculinizing HRT include weight gain, acne, male-pattern baldness, sleep apnea, polycythemia, diabetes, infertility, vaginal dryness, pelvic pain, and clitoral discomfort. Long-term use of masculinizing hormone replacement therapy in trans adults assigned female at birth may be modestly associated with increased risk for hyperlipidemia and hypertension.

     

    Note. Conclusive evidence is lacking about the association between gender-affirming HRT and cardiovascular outcomes since many studies are cross-sectional and non-randomized, and data points about gender identity are often missing from large national datasets. More high quality, longitudinal research is needed to confirm findings in the present literature.

    __________

    Chan Swe N, Ahmed S, Eid M, Poretsky L, Gianos E, Cusano NE. The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review. Metabol Open. 2022;13:100173. Published 2022 Mar 3. doi:10.1016/j.metop.2022.100173

    ​

    Mayo Clinic. (2025). Feminizing Hormone Therapy. Retrieved on November 5, 2025 from https://www.mayoclinic.org/tests-procedures/feminizing-hormone-therapy/about/pac-20385096

     

    Mayo Clinic. (2025). Masculinizing Hormone Therapy. Retrieved on November 5, 2025 from https://www.mayoclinic.org/tests-procedures/masculinizing-hormone-therapy/about/pac-20385099

  • Q |​ What are some side effects of pre-exposure prophylaxis (PrEP) that my patients should know about?

    ​

    Short-term use of daily oral PrEP can cause headache, nausea, vomiting, rash, and loss of appetite and can raise blood levels of creatinine, transaminases, and lactic acid. Long-term use of PrEP may lead to kidney damage and fatty liver disease and reduce bone mineral density. Individual patient risk factors should be considered.

    __________

    Stanford Medicine. (2025). Pre-exposure Prophylaxis. Retrieved on November 5, 2025 from https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/hiv-aids/treatments/prep.html

  • Q |​ What should I know about preparing trans and gender-expansive patients for surgery?

    ​

    In addition to standard pre-operative education and procedures, surgeons and nurses can prepare trans and gender-expansive patients for surgery in the following ways:

    ​

    • Discussions of a potential surgery should use anatomical terms preferred by the patient.
       

    Example. A surgeon may refer to the upper torso of a trans man as “chest” rather than “breast.”
     

    • Early discussions about surgery can include an anatomical inventory, a checklist to document and track the presence or absence of patient organs along with any past surgical procedures. This inventory gives a trans patient the chance to report prior surgeries, including gender-affirmation surgery, and changes to their anatomy that may affect their surgical outcomes.
       

    Example. Before performing surgery, the surgical team may need to assess the potential for pregnancy in a 35-year-old trans man upon learning from the anatomical inventory that he has no history of bottom surgery (no phalloplasty, metoidioplasty, hysterectomy, oophorectomy) and is of child-bearing age.
     

    • Clear and thorough explanations of the surgery and attendant procedures like urinary catheterization are needed so that the patient is aware of what will be performed, and the surgical team knows what equipment will be needed in accordance with the patient’s anatomy.
       

    Example. A nurse explains the instructions for a trans woman’s cardiac surgery and mentions that a urinary catheter will be needed. The patient mentions that she has not had bottom surgery. The nurse reports this to the rest of the surgical team to ensure they know to use a suitable catheter length.
     

    Example. A nurse explains the instructions for a nonbinary person’s hysterectomy and mentions that a urinary catheter will be needed. After asking the nurse about urinary catheterization, the patient expresses concern that the invasiveness of the procedure could trigger their PTSD from a past sexual assault. The nurse consults with the surgical team, planning to take proactive steps to support the patient before and after surgery.

    __________

    Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531-2535. doi:10.1093/jamia/ocab080

  • Q |​ How can my office/hospital unit be more inclusive of trans and gender-expansive people?

    ​

    Make your office or unit more welcoming to and inclusive of trans and gender-expansive people by:

     

    • Wearing your pronouns on your name tag and introducing yourself with your pronouns.
       

    • Using intake forms that provide space for patients to mark their gender identity.
       

    • Display symbols of allyship including the Pride flag and the transgender flag that are visible to patients (such as on a badge or a sticker).
       

    • Be mindful of language used in conversation and in the health record that could be offensive to a trans patient (e.g., terms like “MtF” (male to female) or “FtM” (female to male) may be perceived as derogatory by a trans person). Clarify terminology preferences with the patient if there is uncertainty.
       

    • Hire trans and gender-expansive employees across various roles and disciplines.
       

    • Improve practices in your office/unit through LGBTQIA+ focused training programs and resources.
       

    National LGBTQIA+ Health Education Center of Fenway Health→ has a collection of training resources for healthcare providers.
     

    SAGE Care→ offers LGBTQ+ aging and person-centered care training to professionals in senior living, healthcare, and related fields.

  • Q |​ How can I support trans patients whose access to care is limited by financial and housing insecurity?

    ​

    In connection with social services agencies and community organizations, the interdisciplinary team can provide wraparound services to address financial and housing insecurity for trans patients. As part of the interdisciplinary team, you may:

     

    • Identify respite housing that patients can use to recover after surgery or if they have a chronic illness.
       

    • Be able to find discounted gender-affirming medications and medical supplies for patients with lower incomes.
       

    • Aid trans people in signing up for Medicaid or Medicare, which can offset financial and housing insecurity.
       

    • Identify mutual aid opportunities and small grants for trans people to find housing and afford medical care.
       

    • Contact your state’s social service agency→ or your local community services provider.

     

    These strategies, and others, would help trans adults qualify for surgery, access important medications, get insurance coverage, and find stable housing for more effective healing from acute and chronic illness.

    __________

    National LGBTQIA+ Health Education Center. (n.d.) Gender-affirming Care for Transgender and Gender Diverse People Experiencing Homelessness. Retrieved November 12, 2025 from https://www.lgbtqiahealtheducation.org/courses/gender-affirming-care-for-transgender-and-gender-diverse-people-experiencing-homelessness/

  • Q |​ What is trauma-informed care and why is it important for trans and gender-expansive patients?

    ​

    Trauma-informed care is an approach to care that recognizes signs and symptoms of trauma in patients, families, and staff and integrates knowledge about trauma into policies and practices. It also aims to avoid re-traumatization. The prevalence of PTSD among transgender people is considerably higher than in the general population. Contributors to PTSD among trans and gender-expansive people include financial insecurity, internalized and societal stigma, anti-transgender discrimination and policy, and health barriers. Trans people additionally may be at increased risk for violence, domestic abuse, and sexual assault. It is important to recognize that some trans patients may have a history of trauma and may benefit from supportive measures to address PTSD in the course of clinical care.

     

    Example. A doctor is explaining the need for a digital rectal exam to check the prostate. Her patient, a trans woman with a family history of prostate cancer, seems uncomfortable, so the doctor respectfully acknowledges her discomfort and invites her to say more about what is on her mind. The patient shares that she has a history of sexual assault and that she is worried the exam would remind her of her trauma. The doctor practices compassionate listening and discusses the possibility of alternative approaches to screening.

    __________

    Center for Healthcare Strategies Trauma-informed Care Implementation Resource Center. (2025) What is Trauma-Informed Care? Retrieved November 12, 2025 from https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/

     

    Kirby M, Merriel SW, Olajide O, et al. Is the digital rectal exam any good as a prostate cancer screening test?. Br J Gen Pract. 2024;74(740):137-139. Published 2024 Feb 29. doi:10.3399/bjgp24X736677

     

    Peraud Berthelot W, Fournier H, Hasdenteufel M, Quintard B. Prevalence and associated factors of post-traumatic stress disorders among LGBTQI+ adults: a systematic literature review. BMC Public Health. 2025;25(1):3644. Published 2025 Oct 28. doi:10.1186/s12889-025-24843-1

    ​

    US Department of Veterans Affairs. (2025). PTSD: National Center for PTSD. Retrieved November 12, 2025 from https://www.ptsd.va.gov/understand/common/common_adults.asp

  • Q |​ How can I support my trans patients with advance care planning?

    ​

    Healthcare providers can provide education and guidance about advance care planning for any patient. For example:

     

     

     

    Any healthcare provider can offer trans patients information about advance care planning. The following three advance care planning resources are trans-inclusive:

     

  • Q |​ How do I handoff a patient from one setting to another so that their wishes are respected?

    ​

    To promote patient handoff that is respectful of their gender identity, you can:

     

    • Provide training on the care of trans and gender-expansive patients to staff involved in the handoff and to staff receiving the patient (if at the same institution or health system).
       

    • Use the patient’s name and pronouns.
       

    • Include only relevant details about their gender identity and transition history in your report.
       

    • Emphasize the need for confidentiality as disclosing a trans person’s gender identity and related health information could compromise their safety.
       

    • Avoid sending trans patients to healthcare facilities with a history of discrimination or mistreatment of trans and gender-expansive people.

  • ​Sources

    ​

    Center for Healthcare Strategies Trauma-informed Care Implementation Resource Center. (2025) What is Trauma-Informed Care? Retrieved November 12, 2025 from https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/

     

    Chan Swe N, Ahmed S, Eid M, Poretsky L, Gianos E, Cusano NE. The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review. Metabol Open. 2022;13:100173. Published 2022 Mar 3. doi:10.1016/j.metop.2022.100173

    ​

    Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531-2535. doi:10.1093/jamia/ocab080

     

    Kirby M, Merriel SW, Olajide O, et al. Is the digital rectal exam any good as a prostate cancer screening test?. Br J Gen Pract. 2024;74(740):137-139. Published 2024 Feb 29. doi:10.3399/bjgp24X736677

    ​

    Mayo Clinic. (2025). Feminizing Hormone Therapy. Retrieved on November 5, 2025 from https://www.mayoclinic.org/tests-procedures/feminizing-hormone-therapy/about/pac-20385096

     

    Mayo Clinic. (2025). Masculinizing Hormone Therapy. Retrieved on November 5, 2025 from https://www.mayoclinic.org/tests-procedures/masculinizing-hormone-therapy/about/pac-20385099

     

    Peraud Berthelot W, Fournier H, Hasdenteufel M, Quintard B. Prevalence and associated factors of post-traumatic stress disorders among LGBTQI+ adults: a systematic literature review. BMC Public Health. 2025;25(1):3644. Published 2025 Oct 28. doi:10.1186/s12889-025-24843-1

    ​

    National LGBTQIA+ Health Education Center. (n.d.) Gender-affirming Care for Transgender and Gender Diverse People Experiencing Homelessness. Retrieved November 12, 2025 from https://www.lgbtqiahealtheducation.org/courses/gender-affirming-care-for-transgender-and-gender-diverse-people-experiencing-homelessness/

     

    Stanford Medicine. (2025). Pre-exposure Prophylaxis. Retrieved on November 5, 2025 from https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/hiv-aids/treatments/prep.html

     

    US Department of Veterans Affairs. (2025). PTSD: National Center for PTSD. Retrieved November 12, 2025 from https://www.ptsd.va.gov/understand/common/common_adults.asp

    ​

    Resources

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Page updated January 2026

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