Craig Sweet, MD, an endocrinologist at Fort Myers, Fla.-based Specialists in Reproductive Medicine & Surgery, discussed how healthcare has evolved for transgender patients in an interview with the Fort Myers News-Press.
Dr. Sweet's involvement with transgender patients started in 1989, when he worked in an intersex disorder clinic for his medical school fellowship at Augusta University's Medical College of Georgia.
"I have an unusual perspective because I have been doing it for so long," he told Fort Myers News-Press. "Obviously a lot has changed."
Here are four insights on the evolution of transgender healthcare from the interview:
1. In 1989, the rules for medical transition were more rigid. "When I was in residency, if a person wanted to transition they had to live the role for a year. Then they had to have surgery. Then hormonal treatment. Now I need a letter from a skilled mental health professional evaluating the patient to initiate treatment," Dr. Sweet said.
2. Now, patients are encouraged to transition to what level they feel most comfortable, whether it involves lifestyle changes, hormonal changes or both. "You could have a patient who lives the lifestyle and transitions hormonally but decides not to go through the surgical changes. And others who go full court press," he said.
3. Female-to-male transitions are catching up to male-to-female transitions. "[I]n the past there was a 10-to-1 ratio of male-to-female transitions. In 2017, out of 40 of my transgender patients, I had 25 transitioning from male to female and 15 from female to male," according to Dr. Sweet.
4. Despite these advances, Dr. Sweet said transgender patients still struggle to seek healthcare and urged physicians to educate themselves on the transgender patient population. "I really think these patients have tremendous difficulties finding good medical care," he told Fort Myers News-Press. "Part of my responsibility is to educate regional physicians how to do this. It's a joy to take care of so many of these patients because they are so much happier. They are in much better places now."