Dr. Malley is committed to providing inclusive care to patients who are transgender, gender non-conforming, or questioning. As a gynecologist/human rights activist, I believe that I offer sensitive medical care in a safe and respectful environment.
If you have a vagina, a cervix or breast tissue, it’s important to make regular visits to a gynecologist—regardless of your gender or sexuality. Your gynecologist can provide cancer screening, sexual health checkups and safer sex advice. There’s nothing about this that has to be particularly gendered in order to get the job done.
Unfortunately, finding adequate medical care can be a huge issue for trans people. A study by Gretchen P. Kenagy in Philadelphia found that 26% of respondents had been denied healthcare because they were transgender, and 52% of respondents had difficulty accessing health services. A survey of young transgender and genderqueer Canadians found that a third of respondents aged 14–18 and half of those aged 19–25 missed needed physical health care. Only 15% of respondents with a family doctor felt very comfortable discussing transgender issues with them.
If you currently have a gynecologist with whom you feel comfortable, coming out to them is an important step to being healthy. Being open about your sexual orientation, sexual behavior and gender identity means that your provider will be able to offer care that is personalized and relevant to you. Bring a friend for support if you want to. Tell your healthcare provider your pronouns and the names you prefer that they use for your body parts. They should respect this and start to use your preferred terms.
If your gynecologist is not understanding, or your don’t feel comfortable with them, find a new one — or try our office, if you are in the area. In the US and Canada you can also check with My Trans Health, Rad Remedy or The Gay and Lesbian Medical Association.
Remember, your health is important. When you visit your healthcare provider, you deserve to be addressed with the correct name and gender, and treated with respect and dignity — both by your physician and by the other staff.
If you feel nervous about going to see an OB/GYN, first take a moment to think about what can help you relax. This could include breathing exercises, listening to music or other activities that have helped you in the past. You might want to bring a friend or family member as a support person. They could travel to the appointment with you, accompany you in the waiting room and when you talk to reception staff, observe the doctor’s behavior and advocate for you if needed. If you want, you can ask them to take a note of any medication or tests that your OB/GYN recommends. Everyone’s needs are different, so discuss what types of support you want before, during and after your appointment.
Tell your doctor your pronouns and the names you prefer that they use for your body parts at the consultation. They should respect this, and if they don’t, you might want to find another physician. Your health is important, and you deserve to be treated with respect and dignity.
If you have a uterus and ovaries, and you're over 21, you may need a Pap test. The Pap test looks at cells from the cervix to see if there are any signs of cancer. Tell your doctor what they can do to help you to feel comfortable. We'll also plan out when and how often you should get a Pap test done. If you have a vagina and sexually active, you should get checked for annually for STDS.
Whether you have breasts or not, it’s important for the doctor to examine your chest. Breast cancer can affect people of any gender. Tell your doctor about any family history of breast cancer, and let them know if you have breast pain, lumps or any other changes that worry you.
If you menstruate, the doctor will probably ask you for the date of your last period. If you use the Clue app you’ll have a record of this as well as other information like your average cycle length and period length. Now’s a great time to your doctor about pain, regularity, heaviness or any concerns you may have.
It can feel awkward, but there are many benefits to discussing your sexual function and behaviors with your gynecologist. Everyone is different, but some topics you might want to discuss include: Screening for STDs and HIV, getting vaccinated for HPV and hepatitis A and B, birth control and safer sex, problems with sexual function or satisfaction and plans to adopt or conceive children. Male trans patients taking testosterone absolutely need to consider contraception!
After the appointment, you might want to de-stress by chatting with your support person, exercising or expressing yourself through art or music. Do what works for you. Celebrate the fact that you’ve taken an important step in caring for yourself and your health!
But don’t stop there. Educate yourself on gynecological health so you can be a better advocate for yourself and others. The book Trans Bodies, Trans Selves is a comprehensive guide covering health, legal history, theory and more. Online, the LGBT Healthlink blog has lots of useful info, The Center of Excellence for Transgender health offers educational materials and community links and Rad Remedy are publishing a free series of health guides related to trans and queer health.
Medical appointments like this can bring up feelings of gender dysphoria. If you are struggling or simply need someone to talk to, there are many places to turn: Trans Lifeline is a Crisis hotline in the US and Canada run by and for trans people, and Laura's Playground is a support site for trans people with trained online counselors. (edited from Jen Bell, helloclue.com, March, 2017)
What You Should Know Whether you’re straight or gay, a healthy relationship means you:
- can express yourself honestly, without fear
- make decisions together
- have sex only when you both feel it’s right
- feel respected and valued
- feel supported to follow your goals and dreams
Signs you’re in an unhealthy relationship include a partner who:
- calls, texts or IMs you constantly
- checks your email without your OK
- embarrasses or insults you in front of other people
- doesn’t let you spend time with anyone else
- criticizes the way you look
- threatens to hurt you if you break up
Looking for More Info?
- loveisrespect.org
- dayoneny.org
- If you do not feel safe in your relationship, call 800-621-HOPE (4673) or 311.