Transgender, gender-diverse people face substantial barriers to fertility care
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ANAHEIM, Calif. — Only half of hospitals across the United States offer health care specifically to transgender and gender-diverse people, and only 23% of those offer fertility care to this population.
“We wanted to do a study that would give us a better idea of not only what is available for trans and gender-diverse patients when they are accessing fertility care, but also ways that we can be supportive and improve care, and how we can seek to help that community meet their needs when it comes to family building,” Samantha L. Estevez, MD, a fellow in reproductive endocrinology and infertility at the Icahn School of Medicine at Mount Sinai and the Reproductive Medicine Associates of New York, told Healio.
Estevez and colleagues reviewed the websites of 654 adult and children’s hospitals, including a minimum of five hospitals per state and in Washington, D.C. They excluded specialty hospitals and military and veteran health care centers.
In their review, the researchers noted each hospital’s medical school and religious affiliations, availability of fertility care, availability of gender care for transgender and gender-diverse patients and presence or absence of fertility care for transgender and gender-diverse patients.
Of all hospitals surveyed, 501 (76.61%) were affiliated with medical schools and 165 (25.23%) had religious affiliations.
In total, 335 (51.22%) of hospitals offered care specifically for transgender and gender-diverse people, with 37% providing primary care, 36.85% providing endocrinology services, 33.03% providing psychiatric care and 22.05% providing surgical care. Pediatric hospitals were more likely to offer care to transgender and gender-diverse people compared with adult hospitals (75% vs. 41.67%; P < .0001).
Only 77 (11.77%) of the hospitals surveyed offered specific fertility care to transgender and gender-diverse people, and referrals to fertility care were offered at only five hospitals (0.76%).
Estevez said it is important for hospital systems to keep information on their available services updated online so that more patients are able to access the care they need.
“As [reproductive endocrinology and infertility specialists], we have to look toward making other people within the medical community aware that we are ready to provide care for this patient population,” Estevez told Healio. “It also has to be reinforced in the collaborative care model when it comes to trans and gender-diverse patients because it is one of those things that could easily fall through the cracks.”