Looking at a new Primary Care Physician

[SuzanneS]

Sooo.....my doctor/primary care physician that I've used since I was basically 6 yrs old decided to up and retire(without asking me!). I loved the guy, he was great, but he's gotta do what he's gotta do. He never knew of me being TG, though...

So the local docs aren't really an option...

So I'm looking for a new Primary Care Physician (PCP) in Des Moines or the greater metro area and I'm thinking about finding one that advertises that he's LGBT friendly....mostly because I'm really thinking of telling him/her that I'm TG and I want to know my options........is this a good idea, or should I find a totally separate doc for HRT and should I find yet another for therapy that I don't even know if I need or not?

I would like to explore my options...I'm going crazy sitting here not doing anything about how I feel to myself. Any advice?

Suzanne

[LeaP]

Yes. Start with your head before your body. Medical options are irrelevant until you know you need them.

Find a therapist.

[whowhatwhen]

IIRC Your therapist makes the referral to an endocrinologist, not a whole lot of GPs are willing to handle TS HRT.
What you could do is mention to a perspective doctor that you're transgender and if they would be okay with that.

If they say no then move on, if yes, then you've probably got someone who won't hate dealing with you.
Take it slow and one step at a time, hunt around for a therapist with trans experience but you've got a bit to go from then before HRT is on the table.

[SuzanneS]

Okay...so one of the docs that I've checked out is openly gay and at least one the web, it says that his practice is open to LGBT patients......

[Angela Campbell]

Are you full time? If not there isn't any reason to tell a pcp anything.

Find a therapist, find out if transition is right, then find the right doc for hrt.

[Kathryn Martin]

I think there are two questions really behind your post. You are looking for a primary care physician as a family doctor so you are comfortable with your general health care. If you can find someone who fits the bill and has LGBT credentials that would be best. Did I get that correct.

Most doctors if properly prepared (and have a recommendation from a clinical psychologist and Guidelines for treatment of adult transsexuals (can be found online if you know where to look)) will prescribe spironolactone, finesteride and estrogen. It is not rocket science. Unless of course they have religious or political objections to transsexuals in general.

[LeaP]

As an FYI ... "LGBT Friendly" often translates to "LG Friendly"

[whowhatwhen]

Are you full time? If not there isn't any reason to tell a pcp anything.


Not necessarily, it's probably better to find out if they will have a problem with you before committing to them.

[Angela Campbell]

I don't know, but I don't think I have ever committed to one before. I go to one and if I like them i will continue to use them if not i choose someone else.

[Marleena]

I think I may need to be committed.:heehee:

I guess finding a TG friendly PCP depends on one's intentions. If they will be taking care of an HRT issue then TG friendly by all means. If you'll be presenting as female, same thing. I never came out to my family doctor that I had until I was on HRT for awhile and he needed to know. I asked him at that point if he knew what transgender people are and if he was okay with it. He said yes and I said well you have one now (his only one)! I do have a separate therapist and endo to take care of gender related issues though.

[DebbieL]

Actually, finding a TG friendly doctor can be very important. In my lifetime, I've had a few doctors who were not LGBT friendly, and as a result, they told my parents NOT to tell me things that I probably should have known.

Your BEST choice is to find doctors who are LGBT friendly. You still need to see a therapist, who will evaluate whether you are a good candidate for transition or not, and help you plan that transition. Often, if the doctor already has TG patients, he or she may be able to administer hormones and monitor levels as you transition. If not, he or she may be able to refer you to an endocrinologist who can do this for you.

Doctors to AVOID:
Doctors whose primary or sole privilidges are at faith based hospitals, especially Catholic, 7th Day Adventist, Lutheran, or other faiths that reject the legitimacy of LGBT people, especially those who consider Transsexuals to be "An Abomination". They won't openly thwart you, but they can misdirect, delay, and discourage you in dozens of subtle ways.

Doctors whose medical background include such faith based schools and hospitals.

Doctors, especially endocrinologists, who focus on fertility and baby making. Often this is a reflection of religious beliefs.

Doctors who are "Traditional".

Before you even make an appointment, you should tell the receptionist on the phone that you are transgender and looking for a doctor who is supportive. If the receptionist gives you the run around, or tries to schedule you for 3 months from now, you know to avoid that office.

Is there diversity within the practice. If all the names sound like people from the same country, and all the doctors are men and all the nurses are women, you probably won't want to go there. If there are male and female doctors in the group, and male and female nurses, and/or diversity of races or cultures, then you probably have a good candidate.

Cross-check your health insurance provider's list with the doctors on the LGBT friendly lists. There are usually at least a few who match.

My wife told her doctor that I was transgendered when the doctor said she had been an endochrinologist. She said she couldn't supervise my hormones, not a good candidate.

The strange thing is that med techs don't like to report unusual findings. When I went for a liver ultrasound, the tech was having trouble finding my liver. I joked and said "Is my uterus in the way?". She chuckled and then got a really puzzled look, said "Oh my God!", and then found the liver. No mention of the unusual findings on the report. According to the doctor's version of the report "Everything looked normal". What was "Oh my God" about?

I found the therapist first, then I finally went to Mazzoni Center. It's a bit of a trek to Philadelphia, but I just happened to land an engagement there for 6 months. He did the physical exam and could see that I was already living femme. I'd come over from work. He also knew my therapist and I had the letter from her saying I was a good candidate for transition. He started me on hormones, but did say I had to meet with their social worker as well.

The interview took less than 30 minutes, by which time, he was very clear that I would be a perfect candidate for transition.

There are centers that focus on the LGBT community. This often a good option for "one stop shopping". I doubt you'd find one in Des Moines Iowa, or Rapid City South Dakota, but many large cities have large openly gay populations. These are often the zip codes you want to check out for Doctors.

[SuzanneS]

The way that I came across this doc was by going to the GLMA.org website and looking for a provider. The description under his listing is as follows...."Family Practice, Transgender - Hormones - FTM, Transgender - Hormones - MTF,
Transgender - Transition Services Referrals"

I figured that he'd be worth a try. Iowa doesn't seem to have an abundance of doctors for this type of thing from what I can tell.

Suzanne

[KaceyR]

I'm having to shift my primary care myself.
My old doc (GP and never knew any of my Trans stuff) changed to kind of an 'urgent care' operation so isn't doing primary care work anymore. And other docs in their group they suggested seemed to not be worth much.
So I bided my time holding off picking one. As well as being a thing of timing because in the meantime I've been going to a therapist. Leading up to...
Now with my HRT letter and with suggestions from the therapist as well as our state TG helping group website transgendermichigan.org (similar to yours Suzanne..but TG community-sourced instead of medical community sourced) I've got a new doc that'll be doing it all in Oct. (Had to also compare with insurance acceptance in mind too-a few of the therapist's suggestions didn't take my insurance company).
Upside/Downside is from reports on the doc..he's well known to really dig into any possible issues health wise.
Think my orig doc wasn't so much proactive (and a part of me was glad to ignore or 'not know' :)) We'll see how it goes.

[LeaP]

If you find an honest-to-God gender therapist, you'll find that most know the local doctors who deal with their clients.

[PretzelGirl]

I think you should be able to come out to you doctor when you want to. Their job is to give you advice on your health care. If they don't know everything going on, then they can't give proper advice. I came out to my PCP over 2 years before starting hormones. It has led to him educating himself and to him always looking out for my interests. I know I have a gem, but it shouldn't be amazingly difficult to get someone that will work with you.

[Melissa_Rose]

Please don't judge a doctor by the staff or the group. Statistics apply to everything. Most doctors are male. Most nurses are female. I know those trends are shifting some but the vast majority of the front staff and nurse applications will be female.
I would recommend interviewing your perspective doctor as for past experience, comfort, and knowledge for your issues.
After all you are making an informed choice as to who you want to be your physician not just looking for anyone who will take you.

[Aimee20]

Actually, in des Moines the planned parenthood clinics handle hrt for transsexual patients. I use them for hrt out of Lincoln NE and also have a separate pcp for everything else. Both clinics know what is going on and if there are any problems they talk to either to provide updates.