Transgender trauma patients: What surgeons need to know

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Seek out training on treating transgender patients

Education on the care of transgender and gender nonbinary population is lacking in both medical schools as well as surgical residencies, and it is often left to individual surgeons to seek out their own training. Unfortunately, this leaves many uncertain how to ask a patient about his/her/their history without making the patient uncomfortable. If we don’t ask the right questions, some patients may not disclose information that could be very detrimental to their care. Documentation in EHRs can be made difficult if the software doesn’t include transgender female, transgender male, and gender nonbinary options in addition to the binary choice of female or male. This can contribute to the misgendering and distress of the patient.

Asking which pronouns a transgender individual uses can be a big first step because it allows that person know that you are being respectful. Be prepared for pronouns you may not be used to: Some may use she/her or he/his, and some may use they/their, ze/hir, ze/zir or xe/xyr. It is important to have appropriate registration forms, gender neutral bathrooms, and respect and discretion from every individual provider for all of our patients. Providers should seek out education and training so that the patients aren’t forced to do the educating themselves. As trauma and acute care surgeons, we are used to caring for a diverse patient population with many unique needs. However, we don’t know enough about the trauma and surgery risks in the transgender and gender nonbinary population as only a limited research has been done. Studies such as this by Dr. Mandell et al. are encouraging and hopefully more will follow.

Andrea Long, MD, is an acute care surgeon and an assistant clinical professor at University of San Francisco, Fresno.



Dr. Mandell and his coauthors reported having no financial disclosures.

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