Multi-disciplinary approach to the transitioning patient.
During my training years, one of the topics that was emphasized was the importance of treating the whole patient. This concept was often achieved by forming teams of providers from different specialties to work together to treat a patient. A common example are cleft lip and palate teams. A cleft team often includes a pediatrician, a mental health therapist, a speech therapist, a social worker, an ENT doctor, a plastic surgeon, an orthodontist, a pediatric dentist, and an oral and maxillofacial surgeon. By working together we could truly treat the whole patient inside and out. As cleft patients often require multiple surgeries throughout their lifetime, we would attempt to schedule surgeries not only when developmentally and atomically appropriate but also during school breaks so it would be less burdensome for the patients and their families. The cleft team I was a part of actually took it to the next level and would have a weekly half day clinic where the patients would could go for one afternoon and sit in one room, and all of the providers would go room to room to see them. This scheduling allowed a patient and their family to only have to be out for one afternoon, yet could accomplish up to nine appointments. Additionally, after seeing all of the patients, we providers would sit in a conference room and discuss each patient individually to come up with the best treatment plan and recommendations for each child.
With this concept in mind, while I was in Seattle, I was a part of a group that would meet regularly for our transitioning and transgender patients. In full transparency, this group started because trans-medicine has not traditionally been taught in medical schools, so we as providers would reach out and help teach and learn from each other while discussing complicated patients. This grew into not only a larger group of providers but also resource center with support groups for patients.
I am now proud to say that here in Oklahoma City, we have formulated a multidisciplinary group for our transitioning patients here. Our group includes adolescent medicine and primary care doctors, dermatologists, endocrinologists, surgeons, mental health therapists, along with support group contacts and more. I serve as one of the founding surgeons for the group, and we meet regularly and offer support not only to each other but also to our patients by having a team that communicates about pressing issues and knowing the best resources available for our patients. We also act as advocates for our patients in the community and strive to educate the public. The transitioning process and the gender dysphoria associated with it can be challenging enough for many patients, so to one day have a central clinic for patients to come to just as my cleft patients did, could reduce this burden and thereby better our patients’ journey.