In an article by The Rheumatologist, HSS rheumatologist Michael D. Lockshin, MD, and director of community engagement, diversity and research Jillian Rose, LCSW, MPH, explained how to communicate with patients about gender identity while providing medical care.

Rose noted that the patient intake process is a good time to ask about the patient's sex at birth, gender identity, preferred pronouns and sexual orientation. At HSS, new patients are asked about their gender, sex at birth and preferred pronoun - and all information is entered into their electronic health record.

"Knowing the answers to those questions allows clinicians to refer to patients with dignity and respect, and fosters trust from the beginning of the medical encounter," she added.

The reporter also spoke to HSS patient Alexander William Rose Beckenstein, a transgender man, who is treated for mixed connective tissue disease (MCTD). He said that his "current doctor has been wonderful and fully respectful, but those interactions are few and far between." Mr. Beckenstein explained that some healthcare providers have made him feel like "just another female body" rather than an individual with his own unique identity.

When considering treatment options, Dr. Lockshin stressed that rheumatologists must consider the patient's sex, gender, family planning goals and sexuality.

"Choices of medications are dictated by the fertility and pregnancy desires," Dr. Lockshin said.  

"Being aware of these issues is a key first step. However, making the information relevant to clinical practice is critical," Rose explained.

According to Rose, HSS implemented mandatory training in 2015 for registration and patient access staff on LGBT healthcare disparities, sensitivities and potentially challenging patient scenarios.

"If a clinician selects the chart of a patient who has identified as intersex… a best practice warning pops up", said Rose. This function is to make the clinic experience feel more inclusive to patients.

Read the full article at the-rheumatologist.org. This also appeared in the July print issue.