Dr. Ng: My Hero in Transgender Healthcare!

Things have been surprisingly busy in this strange transitional phase between med school and residency.  So pardon the cobwebs and I'll do my best to keep this more current!  But in the meantime, bear with me as I play catch-up and try to cover a few awesome things I've been able to experience over the past month-- beginning with an LGBT-positive experience I had at MSU!


We (MSU medical students) were fortunate to meet with Dr. Henry Ng, who took time out of his very busy schedule to sit down with our MedFLAG (Medical Friends of Lesbians & Gays) group.  Dr. Ng is a board-certified physician in internal medicine and pediatrics, one of our very own (an MSU-CHM alum), and co-founder and medical director of Cleveland's PRIDE clinic, the only LGBT-centered medical home in the entire state of Ohio!

Group photo of some of MSU's MedFLAG leadership with Dr. Ng!
(I'm hiding in the back, fifth from the right)

It was such a pleasure to hear some of his insights on becoming a strong advocate and competent physician for LGBT patients.  He emphasized the importance of really reaching out in the community and gradually establishing trust with LGBT patients, many of whom may be wary of physicians due to negative experiences in the past.  But with a little extra effort (using LGBT-inclusive forms and patient materials, training culturally sensitive staff members, advertising in queer publications, promoting word of mouth, etc.), it is definitely possible to put oneself out there as a LGBT-informed provider.

One of Dr. Ng's areas of expertise is transgender health, and I shared my frustration with him over the difficulties of providing best-practices health care for trans patients.  When I was in NYC, I read through the Fenway Guide and felt like I had a handle on recommendations for trans healthcare.  However, a lot of what I learned came into question after attending a "meeting of the minds" facilitated by the Callen-Lorde Community Health Center to create national consensus guidelines for trans healthcare.  I discovered that there is not always total agreement on clinical management of trans patients -- such as how to initiate hormonal therapy in treatment-naive and treatment-experienced patients -- and found the multiple complexities overwhelming as a lowly med student still very new to the field.

As medical students, I think we become accustomed to operating under well-established protocols based on the best evidence available, which usually includes multiple randomized controlled trials (the most reliable study design).  However, there is a glaring lack of research on transgender health, and clinical decision-making is not so black-and-white.  Most of what people do in this area of health care is based on guidelines, as mentioned above, that have been put together by LGBT-focused health providers who have worked with trans patients for a number of years and developed some standards for primary care.  It is not 100% perfect, but until research efforts are really amped up around transgender care, our best resource is communicating with other providers in the field, identifying resources, and applying the most updated guidelines (for example - http://transhealth.ucsf.edu/) to one's practice.

Dr. Ng also spoke of efforts in his own clinic to promote cross-training of providers.  For example, the HIV specialist can train the doc who manages hormonal therapy for trans patients, and vice versa.  This allows for more broadly trained physicians who can offer more comprehensive primary care and further develop a bond of trust with their trans patients.

As LGBT advocates in medicine, we must realize that we are pioneers who should be prepared to take initiative in this field-- we have to read, research, talk to experts, reach out to patients, and continually strive to provide quality healthcare for this often underserved demographic.  I would challenge people from all fields and all walks of life to become informed about LGBT issues in general so that we can create a more LGBT-positive society overall.  Are you up to the challenge?