Barriers to Healthcare and Disclosure of LGBTQIA + Identity for Transgender Males in Obstetrics and Gynaecology
American Journal of Internal Medicine
Volume 8, Issue 2, March 2020, Pages: 78-83
Received: Jan. 13, 2020; Accepted: Mar. 6, 2020; Published: Mar. 18, 2020
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Madeleine Noelle Olding, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
Shuangyu Li, Clinical Communication Unit, King’s College London, London, United Kingdom
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Changes in culture and legislation have brought inclusivity and cultural competence to the forefront of medicine. Clinicians must be competent at delivering care for minority-status individuals, such as those who identify as transgender. The purpose of this study is to review the literature regarding the transgender patient group’s experience of healthcare, and to propose suggestions for outcome improvement in transgender medicine. English-language articles published after 2010 were searched for under the headings ‘transgender Gynaecology’ on PubMed and ‘female-to-male transgender disclosure Gynaecology’ on Ovid. Journal articles on disclosure of female-to-male transgender status in Obstetrics and Gynaecology were selected for analysis. Qualitative themes were identified and categorised under four main headings: barriers to access; forms of disclosure; clinician facilitation; implications for Obstetrics and Gynaecology. Twenty-five journal articles were included. Systemic stigma was a considerable force in determining whether patients felt properly managed within their healthcare system. Structural changes such as renaming ‘Women’s Health Services’ to ‘Reproductive Health Services’ and embedding transgender medicine into healthcare curricula could improve the experiences of transgender men in Obstetrics and Gynaecology.
Obstetrics and Gynaecology, Transgender Males, Disclosure, Stigma, Feminist Medicine, LGBTQIA+ Medicine
To cite this article
Madeleine Noelle Olding, Shuangyu Li, Barriers to Healthcare and Disclosure of LGBTQIA + Identity for Transgender Males in Obstetrics and Gynaecology, American Journal of Internal Medicine. Special Issue: Feminist Medicine. Vol. 8, No. 2, 2020, pp. 78-83. doi: 10.11648/j.ajim.20200802.16
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Equality Act 2010, Ch 1, s. 7.
Obedin-Maliver J, Makadon HJ. Transgender men and pregnancy. Obstet Med. 2016; 9: 4-8.
Valenta T, Shade K, Lieggi M. Experiences of transgender individuals when accessing health care: A qualitative systematic review protocol. JBI Database Syst Rev Implement Rep. 2016; 16: 628-634.
Jaffee KD, Shires DA, Stroumsa, D. Discrimination and Delayed Health Care Among Transgender Women and Men: Implications for Improving Medical Education and Health Care Delivery. Med Care. 2016; 54: 1010-1016.
Unger CA. Care of the transgender patient: a survey of gynecologists' current knowledge and practice. J Womens Health (Larchmt). 2015; 24: 114-8.
Smalley KB, Warren JC, Barefoot KN. Differences in health risk behaviors across understudied LGBTQIA subgroups. Health Psychol. 2016; 35: 103-114.
Unger CA. Care of the transgender patient: the role of the gynecologist. Am J Obstet Gynecol. 2014; 210: 16-26.
Committee on Adolescent Health Care. Committee Opinion No. 685: Care for Transgender Adolescents. Obstet Gynecol. 2017; 129: e11-e16.
Carabez RM, Eliason MJ, Martinson M. Nurses' Knowledge About Transgender Patient Care: A Qualitative Study. ANS Adv Nurs Sci. 2016; 39: 257-271.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and MetaAnalyses: The PRISMA Statement. PLoS Med. 2009; 6: e1000097.
Mereish EH, Poteat VP. A relational model of sexual minority mental and physical health: The negative effects of shame on relationships, loneliness, and health. J Couns Psychol. 2015; 62: 425-437.
Rood BA, Maroney MR, Puckett JA, Berman AK, Reisner SL, Pantalone DW. Identity concealment in transgender adults: A qualitative assessment of minority stress and gender affirmation. Am. J. Orthopsychiatry. 2017; 87: 704-713.
Romanelli M, Hudson KD. Individual and systemic barriers to health care: Perspectives of lesbian, gay, bisexual, and transgender adults. Am J Orthopsychiatry. 2017; 87: 714-728.
Porsch LM, Dayananda I, Dean G. An Exploratory Study of Transgender New Yorkers' Use of Sexual Health Services and Interest in Receiving Services at Planned Parenthood of New York City. Transgend Health. 2016; 1: 231-237.
Wingo E, Ingraham N, Roberts SCM. Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQIAQ People Assigned Female at Birth: A Qualitative Study. Womens Health Issues. 2018; 28: 350-357.
Bachmann GA, Mussman B. The aging population: imperative to uncouple sex and gender to establish "gender equal" health care. Maturitas. 2015; 80: 421-5.
Hoffkling A, Obedin-Maliver J, Sevelius, J. From erasure to opportunity: a qualitative study of the experiences of transgender men around pregnancy and recommendations for providers. BMC Pregnancy Childbirth. 2017; 17: 332.
Ruben MA, Blosnich JR, Dichter ME, Luscri L, Shipherd JC. Will Veterans Answer Sexual Orientation and Gender Identity Questions?. Med Care. 2017; 55: S85-S89.
Abern L, Maguire K. Breaking down barriers to transgender health care: Would a transgender-only clinic help?. Obstet Gynecol. 2018; 131: 8S.
Sherman MD, Kauth MR, Shipherd JC, Street RL. Communication between VA providers and sexual and gender minority veterans: a pilot study. Psychol Serv. 2014; 11: 235-242.
Thornton M. LGBTQIA Older Adults and Nurse Administrators: An Opportunity for Advocacy. Nurs Adm Q. 2018; 42: 129-135.
Obedin-Maliver J. Time for OBGYNs to care for people of all genders. J Womens Health (Larchmt). 2015; 24: 109-11.
Urban RR, Teng NN, Kapp DS. Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance. Am J Obstet Gynecol. 2011; 204: e9-e12.
Fein LA, Wong A, Honorio D, Salgado CJ, Medina CA. Transgender men's experiences with and perceptions of gynecologic care. Obstet Gynecol. 2017; 129: 44S.
Frecker H, Scheim A, Leonardi M, Yudin M. Experiences of transgender men in accessing care in gynecology clinics. Obstet Gynecol. 2018; 131: 81S.
Garrett MB. Working With Transgender Individuals in Case Management Practice. Prof Case Manag. 2018; 23: 19-24.
Stroumsa D. The state of transgender health care: policy, law, and medical frameworks. Am J Public Health. 2014; 104: e31-8.
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