Building an Academic Transgender Medicine Center of Excellence: The 5-Year Johns Hopkins Experience

Andrew A Marano¹, Melissa Noyes², Lauren Eisenbeis³, Helene F Hedian⁴, Kara Segna⁵, Paula M Neira⁶, Kate Thomas⁷, W P Andrew Lee⁸, Richard J Redett⁹, Devin Coon¹⁰

Affiliations

¹ A.A. Marano is a gender and microsurgery fellow, Brigham Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts.
² M. Noyes is program manager, Brigham and Women's Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts. At the beginning of this work, the author was program coordinator, Center for Transgender Health, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ L. Eisenbeis is lead physician assistant, Luminis Health, Anne Arundel Medical Center Plastic and Reconstructive Surgery Group, Annapolis, Maryland. At the beginning of this work, the author was a physician assistant, Johns Hopkins Center for Transgender Health, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁴ H.F. Hedian is assistant professor of medicine, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁵ K. Segna is assistant professor of anesthesiology and critical care medicine, Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ P.M. Neira is clinical program director and founder, Johns Hopkins Center for Transgender Health, program director, LGBTQ+ Equity and Education, Office of Diversity, Inclusion and Health Equity, Johns Hopkins Medicineassistant professor, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁷ K. Thomas is director of clinical services, Sex and Gender Clinic, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁸ W.P.A. Lee is professor, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. At the beginning of this work, the author was professor and director, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁹ R.J. Redett is professor and chair, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
¹⁰ D. Coon is clinical director, Brigham Center for Transgender Health, Brigham and Women's Hospitalassociate professor, Harvard Medical School, Boston, Massachusetts. At the beginning of this work, the author was chief medical director and founder, Johns Hopkins Center for Transgender Healthassociate professor, Departments of Plastic and Reconstructive Surgery and Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.

PMID: 36608643
DOI: 10.1097/ACM.0000000000005135

Building an Academic Transgender Medicine Center of Excellence: The 5-Year Johns Hopkins Experience

Andrew A Marano et al. Acad Med. 2023.

. 2023 May 1;98(5):569-576.

doi: 10.1097/ACM.0000000000005135. Epub 2023 Jan 3.

Authors

Andrew A Marano¹, Melissa Noyes², Lauren Eisenbeis³, Helene F Hedian⁴, Kara Segna⁵, Paula M Neira⁶, Kate Thomas⁷, W P Andrew Lee⁸, Richard J Redett⁹, Devin Coon¹⁰

Affiliations

¹ A.A. Marano is a gender and microsurgery fellow, Brigham Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts.
² M. Noyes is program manager, Brigham and Women's Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts. At the beginning of this work, the author was program coordinator, Center for Transgender Health, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ L. Eisenbeis is lead physician assistant, Luminis Health, Anne Arundel Medical Center Plastic and Reconstructive Surgery Group, Annapolis, Maryland. At the beginning of this work, the author was a physician assistant, Johns Hopkins Center for Transgender Health, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁴ H.F. Hedian is assistant professor of medicine, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁵ K. Segna is assistant professor of anesthesiology and critical care medicine, Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ P.M. Neira is clinical program director and founder, Johns Hopkins Center for Transgender Health, program director, LGBTQ+ Equity and Education, Office of Diversity, Inclusion and Health Equity, Johns Hopkins Medicineassistant professor, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁷ K. Thomas is director of clinical services, Sex and Gender Clinic, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁸ W.P.A. Lee is professor, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. At the beginning of this work, the author was professor and director, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁹ R.J. Redett is professor and chair, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
¹⁰ D. Coon is clinical director, Brigham Center for Transgender Health, Brigham and Women's Hospitalassociate professor, Harvard Medical School, Boston, Massachusetts. At the beginning of this work, the author was chief medical director and founder, Johns Hopkins Center for Transgender Healthassociate professor, Departments of Plastic and Reconstructive Surgery and Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.

PMID: 36608643
DOI: 10.1097/ACM.0000000000005135

Abstract

Gender-affirming care for transgender and gender diverse (TGD) individuals is a multidisciplinary endeavor that requires organized efforts of many specialized practitioners. TGD individuals experience many health care barriers, including the scarcity of multidisciplinary teams formed to coordinate and deliver complex care in an efficient and affirming way. The Johns Hopkins Center for Transgender Health was founded in 2017 with the mission of decreasing health disparities and improving the health of the TGD community. The authors present their experience building the center around a service line model in which patients have 1 point of contact, they are tracked throughout the care process, and the multidepartmental practitioners involved in their care are aligned. This model allowed for a patient-centered experience in which all involved disciplines were seamlessly integrated and the patient could navigate easily among them. With the structure and mission in place, the next challenge was to develop an infrastructure for culturally competent care. Through competency training and adjustment of systems-based logistics, measures were put in place to prevent traumatic experiences, such as misgendering, use of culturally inappropriate vocabulary, and use of incorrect names. Partnerships among colleagues in the fields of plastic surgery, urology, gynecology, otolaryngology, anesthesia, psychiatry/mental health, internal medicine, endocrinology, fertility, nursing, social work, speech therapy, and pediatrics/adolescent care were necessary to provide the appropriate breadth of services to care for TGD patients. Since its inception, the center has seen steady and continual growth, with more than 2,800 patients in its first 5 years. By sharing their experience in creating and developing a center of excellence, the authors hope to provide a blueprint for others to expand health care quality and access for TGD individuals.

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References

1. The World Professional Association for Transgender Health. Standards of care for the health of transsexual, transgender, and gender nonconforming people. https://www.wpath.org/media/cms/Documents/SOC%20v7/SOC%20V7_English.pdf . Accessed May 20, 2022.
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1. Pigot GLS, Al-Tamimi M, Nieuwenhuijzen JA, et al. Genital gender-affirming surgery without urethral lengthening in transgender men: A clinical follow-up study on the surgical and urological outcomes and patient satisfaction. J Sex Med. 2020;17:2478–2487.
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Building an Academic Transgender Medicine Center of Excellence: The 5-Year Johns Hopkins Experience

Affiliations

Building an Academic Transgender Medicine Center of Excellence: The 5-Year Johns Hopkins Experience

Authors

Affiliations

Abstract

References

MeSH terms

LinkOut - more resources

Full Text Sources