Session 100 Dr. Kara Connelly, a transgender medicine specialist. A pediatric endocrinologist by training in an academic setting, she has been out of training now for six years. Today, we talk about Transgender Medicine, why we have it, and why it's important for transgender patients. [04:13] Interest in Transgender Medicine Kara drew inspiration from patients and their families going through hoops they had to go through to access care. Knowing how challenging and difficult it was, she felt passionate about trying to make healthcare easier and more accessible. Additionally, this was in the realm of pediatric endocrinology that it naturally felt like they could build what they did to help more patients access the care they needed. [05:00] Traits That Lead to Being a Great Transgender Medicine Specialist Communication is the most important piece of being a great transgender medicine specialist. This goes for pediatric endocrinology as well. This being said, you also have to be a good listener and open to hearing people's stories and their needs. You also need to have an open mind in helping them access what they need. With pediatric endocrinology, you have to be able to tailor conversations based on who's listening. Be able to get the same points across to patients across different age ranges. [06:26] Types of Patients Kara mentions that one of the things that has been continuing to shift is where patients are accessing care. In this regard, pediatric patients are different from adult patients. Currently, they see patients as specialty care providers. They're often referred to by their primary care providers who are likely to have not had any training in the area since this wasn't included in their medical training. Not long ago, Kara didn't have any access to transgender medicine when she was a medical student. So it's still relatively new for many pediatricians. A lot of family medicine providers are gaining more experience because of their work with adult transgender patients. But many pediatricians are still wanting to refer to specialty care. As part of pediatric endocrinology, one of the treatments they offer is pubertal suppression or sometimes referred to as puberty blockers. These are medications that pause puberty and used for patients who are not transgender and go through puberty too early. This can also be accessed by transgender youth who don't want to go through the physical puberty changes that are not aligned with their gender identity. They also prescribe prosperity hormones to many patients who are not transgender. The patients come to see them pretty often after 3-4 months. They're prescribing hormones in starting puberty so they build relationships with these patients. For young adult and adult transgender patients, they usually access hormones through their primary care providers. So there are not a lot of adult patients that access these medications from adult endocrinologists. However, there also adult endocrinologists that are active in transgender health. [09:44] Focus on Transgender Health There aren't enough trained providers to be able to provide the care that is needed for this patient population. Kara explains that transgender health will be part of medical training and by that time, there will be more primary care providers with the knowledge and expertise to do the care. Pediatric care is a little bit more complicated than adults. But in adults, it usually involves prescribing hormones and monitoring for side effects which are low and rare. It's easy to get the training that's needed to become an expert in transgender health. So it's just a matter of training people. Taking care of this population is critical because transgender people in the U.S. and in the world, are not able to access a lot of the rights and healthcare that other populations are able to. It's important that as a society, we're able to gain awareness of what this means and how important it is to be able to provide basic healthc