Introduction: Recently, in gender confirmation surgery, the peritoneal pull through option for male to female vaginoplasty procedures has arisen as a new exciting procedure. Traditionally, there is the more common option of the penile inversion technique (the McIndoe Procedure is the gynecologic equivalent) and then there is the more complex sigmoid colon vaginal construction procedure usually reserved for salvage or reconstruction. Peritoneal pull through has the theoretical benefit over the penile inversion technique of having lubrication, needing less dilation, less douching, less maintenance, and more depth. This option may be less risky than sigmoid colon vaginas; not having the risk of anastomosis breakdown, having less risk of prolapse, not having odorous mucus discharge, no need for monitoring colon pathology. Due to these benefits, patients are interested and asking more about the peritoneal pull through option. So, do we adopt this procedure as the best option for our patients born without vaginas?

Definition: What is the peritoneal pull through procedure? The medical name for the gynecological version of this procedure is the Davydov Procedure. It is a combination perineal and abdominal approach procedure developed to help women who had congenital absence of their vaginal canal. A vaginal opening was created or further developed on the perineum. Then an abdominal procedure opened and connected the lower developed portion of the vagina to the upper peritoneal/abdominal cavity. Obtaining, dragging the abdominal (peritoneal) lining down, and then sewing the peritoneum to the existing lining or graft from the perineal approach is performed. The top of the opening is then closed to separate the vagina from the peritoneal/abdominal cavity.

Background: Peritoneal pull through procedure was developed by pelvic surgeons to help women with a congenital absence of their vaginal canal. The syndrome associated with an absence of the vaginal canal and other Mullerian associated anomalies is Myer-Rokitansky-Kuster-Hauser Syndrome (MRKH Syndrome).

Incidence: MRKH syndrome affects approximately 1 in 5000 (range 1 per 4000 to 10,000 females). [1,2]

Some surgical procedures offered to MRKH patients are similar to the male to female vaginoplasty procedures:

1a) McIndoe procedure – The McIndoe procedure, which is often used by gynecologists, utilizes a split-thickness skin graft from the buttocks [3,4]. This graft is placed over a form with the dermal side facing the vaginal space/form. This form is kept in place for approximately a week. Postoperative dilation of vaginal lining required. Risks including graft failure, hematoma and fistula are in the range of 5-10%. [5,6,7]

1b) Penile inversion procedure – Also uses split-thickness skin graft from scrotum, groin or lower abdomen for upper portion of vagina, applied in same fashion around a form. The distal opening of the vagina is a full thickness graft of penile skin sewn to the additional split-thickness graft. Dressing and vaginal packing kept in place for 5-10 days, then lifetime dilation, addition of lubrication, douching required. Risks include graft failure, hematoma, fistula, stenosis, stricture, pain, persistent gender dysphoria, wound separation, further surgery. Surgical risks range from 4-60%.

2a & 2b) Sigmoid vaginoplasty – A segment of transected sigmoid is pulled down to the introitus to form a neovagina, and the other end is closed to create a blind pouch. An end-to-end reanastomosis is performed to recreate a patent gastrointestinal tract. The advantage of this procedure over the McIndoe is that maintenance with dilation, adding lube, and douching may not be required. Risks include infection, sepsis, anastomosis breakdown, stenosis at the anastomotic sites, prolapse of the graft, chronic mucus discharge with a foul odour, risks of colonic pathology occurring in graft lining. [8,9,10].

3a) Davydov Procedure – The Davydov technique can be performed open, laparoscopically, robot assisted laparoscopically. Dissection of the rectovaginal space, releasing peritoneum and pulling the lining down to the existing vaginal lining, then sewing both linings together. The proximal/abdominal portion of the vaginal lining is closed with a purse string suture. [11,12,13].

3b) Peritoneal Pull Through Procedure – Just as in the Davydov Procedure, an abdominal approach to obtain peritoneum and develop Denonvilliers fascia between the rectum and prostate to create a space for the neo-vagina or vaginal reconstruction. Risks include all the risks involved in a penile inversion technique if being done concurrently, as well as: stricture, stenosis, graft failure, lack of lubrication, and risks of abdominal procedure of damage to bowel, bladder, prostate, muscles, nerves, and vessels. Another risk is the lack of literature and long term data on this procedure.

Literature: There is very little information on long term outcomes for MRKH and MTF vaginoplasty procedures.

Conclusion: Surgeons are striving for a vaginoplasty procedure which creates the desired features of a natal vagina. Goals for vaginoplasty procedures: to create a vagina which is natural in appearance, has self-lubrication, minimal upkeep (minimal to no dilation, minimal to no douching), functions for sexual experiences, has erogenous sensation, and has acceptable surgical risk. The peritoneal pull through technique is promising for most of the above features, and offers more possible features than either the penile inversion technique or the sigmoid vaginoplasty.

However, there is a paucity of long-term data for MRKH patients with peritoneal pull through procedures and even less information for the peritoneal pull through procedure for MTF vaginoplasty procedures. Caution in performing the peritoneal pull through procedure until more information is available seems prudent.

At this point, this option may be an option for patients who need salvage vaginal reconstruction whose only option is colon procedure or patients who need more grafting than is available by traditional penile inversion technique: gender non-conforming procedures (ie penile preservation vaginoplasty) or patients with atrophic anatomy (congenital, acquired, women who have been exposed to puberty blockers).

We need to have transparency of follow up for these patients in the interest of future informed consent for our patients.

References:

1. Evans TN, Poland ML, Boving RL. Vaginal malformations. Am J Obstet Gynecol 1981; 141:910.
2. Herlin M, Bjørn AM, Rasmussen M, et al. Prevalence and patient characteristics of Mayer-Rokitansky-Küster-Hauser syndrome: a nationwide registry-based study. Hum Reprod 2016; 31:2384.
3. Frank, RT. The formation of an artificial vagina without operation. Am J Obstet Gynecol 1938; 35:1053.
4. McINDOE A. The treatment of congenital absence and obliterative conditions of the vagina. Br J Plast Surg 1950; 2:254.
5. Højsgaard A, Villadsen I. McIndoe procedure for congenital vaginal agenesis: complications and results. Br J Plast Surg 1995; 48:97.
6. Klingele CJ, Gebhart JB, Croak AJ, et al. McIndoe procedure for vaginal agenesis: long-term outcome and effect on quality of life. Am J Obstet Gynecol 2003; 189:1569.
7. WILLIAMS EA. CONGENITAL ABSENCE OF THE VAGINA: A SIMPLE OPERATION FOR ITS RELIEF. J Obstet Gynaecol Br Commonw 1964; 71:511.
8. Pratt JH, Smith GR. Vaginal reconstruction with a sigmoid loop. Am J Obstet Gynecol 1966; 96:31.
9. Kapoor R, Sharma DK, Singh KJ, et al. Sigmoid vaginoplasty: long-term results. Urology 2006; 67:1212.
10. Carrard C, Chevret-Measson M, Lunel A, Raudrant D. Sexuality after sigmoid vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 2012; 97:691.
11. Bianchi S, Frontino G, Ciappina N, et al. Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril 2011; 95:1098.
12. WILLIAMS EA. CONGENITAL ABSENCE OF THE VAGINA: A SIMPLE OPERATION FOR ITS RELIEF. J Obstet Gynaecol Br Commonw 1964; 71:511.
13. Creatsas G, Deligeoroglou E, Makrakis E, et al. Creation of a neovagina following Williams vaginoplasty and the Creatsas modification in 111 patients with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 2001; 76:1036.

Dr. Heidi Wittenberg is an experienced Urogynecologist based in San Francisco who offers transgender bottom surgery procedures, including Orchiectomy, Penectomy, Vulvoplasty and Vaginoplasty. Dr. Wittenberg works exclusively with trans patients. To speak with Dr. Wittenberg about gender affirming genital surgery, please contact her office to arrange a consultation.

Below you’ll find details about confirmed conferences that offer programming specifically for health professionals working with the trans community. Hands-on surgeon training events are also included. Check back periodically for updates as more 2019 conference dates are confirmed.

Note: This list is focused on conferences that have programming for health providers. There are a number of other trans conferences that are not included here as they have a different target audience.

2019 Conferences at a Glance

2019 Confirmed Conferences

Gender Education and DeMystification Symposium (GEMS)
An annual event designed to offer a clinical and educational perspective regarding gender identity. Educational Consultants, clinicians, and program staff who are interested in learning more about shaping the conversation regarding gender awareness and acceptance in the mental health industry are encouraged to attend. Symposium attendees will be given an opportunity to hear from the nation’s leading experts and attend break-out sessions covering a wide range of topics focused on assisting transgender children, adolescents and young adults.

When: February 17-19 2019
Where: Atlanta, GA

Southern Trans Health and Wellness Conference
The Southern Trans Health and Wellness Conference is designed to highlight clinical best practices, innovative research, and community partnerships to support the health and wellness of transgender communities. The conference will bring together more than 300 diverse attendees committed to improving and strengthening our region’s response to transgender health. Designed for advocates, community members, counselors, educators, family members, nurse practitioners, nurses, physicians, physician assistants, psychologists, researchers, social workers, therapists and all others who are engaged with providing (or interested in developing) services for transgender persons.

When: March 7-9, 2019
Where: M.C. Benton Jr. Convention Center, Winston Salem, North Carolina
Cost: $190-$390, early bird discounts available.

Greater Dayton Transgender Mental Health Summit
At this conference, social work and mental health professionals will discuss recent academic research for serving the mental health needs of transgender and gender diverse populations; identify common needs of caregivers/guardians of transgender youth and ways to support the family; connect mental health and social service providers with resources for serving transgender and gender diverse populations. CEs available for Social Workers and Counselors. MCEs available for Psychologists. This event is being presented in partnership with the Equitas Health Institute,  Hearthstone Psychology and the Pyschology Department at Sinclair Community College.

When: March 22, 2019
Where: Sinclair Community College, Dayton, OH

Transgender Mental Health Symposium
Every two years, the Psychotherapy Center for Gender and Sexuality, a division of the Institute for Contemporary Psychotherapy, sponsors a clinical conference exploring the psychodynamics of psychotherapeutic theory and practice in the context of trans identities. The 6th biannual conference will focus on the interplay of clinical practice and theories of development. Presenters will explore issues such as; how are clinicians approaching psychotherapy and psychoanalysis while engaging with traditional and emerging developmental theories?

When: March 29-30, 2019
Where: New York, NY

EPATH
Conference for WPATH members in the EU. Scientific sessions, poster sessions, engaging plenaries, oral abstract scientific sessions and mini-symposia.

When: April 11-13, 2019
Where: Rome, IT

National Transgender Health Summit
The premiere national conference in transgender health. This landmark program will present cutting-edge research, evidence-based educational sessions, training opportunities across many disciplines. The Pre-Summit Conference Transgender Medicine, Surgery and Mental Health Care Clinician Training Institute will be held on April 12.

When: April 13-14, 2019
Where: Oakland, California
Cost: $225-$550, early bird discounts available.

Transgender Competency in Healthcare – Closing the Knowledge Gap
Conference will address approaches to providing respectful and effective nursing care to transgender patients; including, creating an environment where transgender patients feel safe, building therapeutic trust and overcoming past poor experiences, respectfully and effectively collecting health histories, physical exams, providing important health education around sexual/reproductive organs (self exams).

When: April 19, 2019
Where: Nashua, NH
Cost: FREE

Summit to Improve Transgender Collaborative Healthcare (STITCH)
The conference focuses on connecting healthcare providers, community members, and organizations with knowledge and tools for best healthcare practices in caring for transgender and gender non-conforming patients. Topics include hormone replacement therapy, name or gender marker changes, gender affirmative surgery, child and adolescent care, and much more. Healthcare Workforce (nurses, social workers, physicians, NPs, therapists, psychologists, etc) and students (pre-health professions, professional schools, grad schools) are welcome. Presented by MU School of Medicine, MU Sinclair School of Nursing, and the Center for Continuing Medical Education & Physician Lifelong Learning.

When: April 27, 2019
Where: Columbia, MO
Cost: $60-$120

SURGEON TRAINING
Amsterdam Gender Rounds – Round 1: Vaginoplasty
Hands-on instructional training for surgeons includes lectures, instructional videos and e-learning modules, and cadaveric dissesction and discussion groups. Designed by Gender Surgery Amsterdam, the first round is Penile Inversion Vaginoplasty, a WPATH global education initiative certified course.

When: May 9-10, 2019
Where: Amsterdam, NL
Cost: €4,500.00 for surgeons, €550 for team members.

Spring Symposium on Transgender Mental Healthcare
This symposium will offer two days of training in evidence-based best practices of gender affirming care and treatment for transgender and gender non-binary individuals. Hosted by Central Texas Transgender Health Coalition. Continuing education units will be provided by the Texas HIV Connection, which is approved by the Texas State Board of Social Work Examiners, the Texas State Board of Professional Counselors, and the Texas Certification Board of Addiction Professionals to provide continuing education to licensed professionals. Continuing education credits for medical professionals are not available at this symposium.

When: May 10-11, 2019
Where: Austin Community College: Eastview Campus, Austin, TX 78702
Cost: $50-$175

Rhode Island Trans Health Conference
The 2019 conference includes 4 tracks: behavioral health, medical, public health, and community. The medical and behavioral health tracks are designed for health professionals wanting to provide quality care for all transgender and gender diverse individuals. Physicians, nurses, physician assistants, nurse practitioners, psychologists, social workers, licensed mental health providers, medical students, residents, and fellows who provide support and medical care to members of the transgender and gender diverse community are welcome. The public health track is is designed to provide public health professionals with an update on what is known about health disparities and gaps in the literature and health policies regarding the transgender and gender diverse community. The goal of this track is also to focus on strategies for improvement, such as making research and surveillance data collection, and public health policies and programs more inclusive of transgender and non-binary people in order to support community wellness and health.

When: May 18, 2019
Where: Providence, Rhode Island
Cost: unknown

Discussion On Gender Affirmation: Surgery and Beyond
A conference aimed at helping nurses, physicians, mental health professionals, social workers and other healthcare providers grappling with the ethical and practice-related concerns in serving trans individuals who are considering surgery. Sponsored by Saint Francis Memorial Hospital (SFMH) and the World Professional Association for Transgender Health’s Global Education Initiative (WPATH GEI).

Topics to be covered include:

• An ethical framework for navigating challenges in gender care
• Counseling patients/clients regarding surgery options
• Physical preparation for surgery
• Discussions on complications of gender surgeries
• Masculinizing and feminizing surgical procedures
• Nonbinary surgery requests
• Ethical issues in adolescent treatment
• How to be a well-informed healthcare advocate
• Facial feminization and voice surgery

Featured speakers include:

• Dr. Thomas Satterwhite, founder of Align Surgical Associates. Plastic and craniofacial surgeon specializing in gender confirmation procedures.
• Dr. Jordan Deschamps-Braly, plastic and craniofacial surgeon specializing in facial feminization surgery.
• Dr. Bauback Safa, plastic surgeon specializing in microsurgery and phalloplasty.

When: May 30 – June 1, 2019
Where: Kabuki Hotel, San Francisco, CA
Cost: $295-$850

Gender Spectrum Professionals’ Symposium
The Professionals’ Symposium is designed for individuals who serve transgender, non-binary, and otherwise gender-expansive youth and/or their families. Workshops are organized around a variety of disciplines – education, medicine, the law, mental health/counseling, social services, and child welfare.
Workshops for those just beginning in the field of gender-affirmative care as well as a number of in-depth sessions and advanced topics for even the most experienced professionals will be available.

When: July 19, 2019
Where: Moraga, CA
Cost: $280-$380

Philadelphia Trans Wellness Conference
PTWC is the largest free trans conference in the world. The Professional Track (ProTrack) of the Philadelphia Trans Wellness Conference is a three-day continuing education program designed to enhance clinical knowledge and cultural competence for professionals working with Trans, Gender Non-Conforming, and Non-Binary individuals and with the goal to share unique, advanced, and innovative ways to best serve these communities. Protrack will host three professional tracks; Medical, Behavioral Health, and Legal. Each track offers continuing education credits to its audience members and presenters.

When: July 25-27, 2019
Where: Philadelphia, PA
Cost: $100-$490, single day pricing also available.

SURGEON TRAINING
International Facial Gender Symposium
This groundbreaking educational symposium is designed to address the lack of structured academic programs devoted to this emerging field of craniofacial plastic surgery. It will be an immersive 2 day program, with lectures, discussion panels, Q&A sessions, and an all-day cadaver lab, hosted at world famous Johns Hopkins Hospital in collaboration with FACIALTEAM Training & Education. In addition, there will be an evening gathering after the didactic session to encourage thoughtful discussion and innovation in this field. Invited speakers are coming from Europe, as well as some of the leading surgeons offering gender affirming facial surgery in the United States.

When: July 26-27, 2019
Where: Baltimore, MD
Cost: N/A

Gender Odyssey
Gender Odyssey Professional programming (GO Pro) is for professionals and students seeking to advance their understanding of gender diversity and transgender identities in children, teens, and adults. Leading experts will offer sessions covering gender identity across the lifespan and life experience. GO Professional is a 3-day program which includes advanced level sessions for return attendees as well as access to GO Family sessions on Sunday.

When: August 1-4, 2019
Where: San Diego Marriott Mission Valley, San Diego, CA
Cost: $225-$395, single day pricing also available.

USPATH
Conference for WPATH members in the USA. Scientific sessions, poster sessions, engaging plenaries, oral abstract scientific sessions and mini-symposia.

When: September 3-8
Where: Washington DC
Cost: N/A

Transgender Medical Conference
Two day event that offers information and networking for professionals who provide services for transgender patients. Find out more about what the transgender community seeks from medical and mental health professionals; up to date education and best practices in the field of gender non-conforming and gender expansive and adolescence, clinical mental health; hormone replacement for youth and adults; HIV Bio medical prevention and treatment; Gender Confirmation Surgery and much more.

When: September 12-13, 2019
Where: Fort Lauderdale, FL
Cost: $25-$250

Principles in the Care of Transgender and Intersex Patients
Healthcare providers have for the last several years been seeing in their practices an influx of transgender and intersex people seeking sensitive and appropriate care. This pioneering course will offer cutting-edge perspectives and practical evidence-based principles for working with these patients before, during and after transition. Experts and clinicians from Mayo’s Transgender and Intersex Multidisciplinary Clinic will instruct attendees in medical, surgical, psychosocial, legal and ethical issues in transgender and intersex care. Participants will leave with the skills to provide progressive and informed care to this emergent patient population. This course is designed for physicians, advanced care providers and social workers in areas of psychiatry, psychology, endocrinology, family medicine, internal medicine, plastic surgery, urology and pediatrics.

When: September 26-28, 2019
Where: Rochester, MN
Cost: N/A

Gender Infinity
The event has workshops for everyone, including medical and mental health professionals and advocates. CEUs are available for physicians, psychologists, social workers, licensed professional counselors, and marriage and family therapists. The two-day event is an opportunity for trans communities of all ages to unite, build relationships across generations, and collaborate with providers.

When: October 25 & 26
Where: University of Houston Clearlake, Texas
Cost: $170 1-day / $270 2-day for professionals; $250 1-day / $375 2-day for medical professionals.

Advancing Excellence in Transgender Health
This conference is designed to train the whole health care team in providing competent and confident gender-affirmative health care, grounded in research evidence and best clinical practices. Sessions are led by expert faculty specialized in transgender-focused research and patient care. The conference is appropriate for all members of health care teams, including physicians, behavioral health care providers, physician assistants, nurses, and other staff.

When: November 1-3, 2019
Where: Boston Park Plaza Hotel, Boston, MA
Cost: N/A

GenderWorks
Dedicated to providing medical and mental healthcare providers with education and training on how to competently serve transgender patients and clients. The conference also provides training for educators seeking to advance the rights of transgender and gender diverse students, and policymakers seeking to help the community. This conference is hosted by the Professional Transgender Resource Network (PTRN) in collaboration with the University of Nebraska Medical Center (UNMC).

When: November 8, 2019
Where: Omaha Hilton Downtown, Omaha, NE
Cost: $80-$180 before 08/01; $225 after.

Do you know of other trans conferences for health professionals? Please add them in the comments area below!

Last updated: 09/22/19

Safer Sex For Trans Bodies is a guide for transgender and gender expansive people, partners and lovers that helps answer questions about safer sex. In this free PDF, you’ll find information about sex during and after transition, ways to
talk to your partner(s) (romantic, casual and transactional) about sex and suggestions for exploring your own sexuality, whether you have many partners, one partner, or you’re going solo.

Topics include:

• Language/Terminology
• Masturbation
• Talking About Sex With Partners
• Dating & Personal Safety
• STIs and Safer Sex Activities
• Safer Sex Tools
• BDSM and Kink
• Sex During Transition – Hormones & Surgery

Download the PDF here.

The content of this guide was developed by Bianca Palmisano of Intimate Health Consulting. Produced by Whitman-Walker Health and the Human Rights Campaign.

Also see: Trans Health Matters – Published in 2012 by the UK’s Terrence Higgins Trust, Trans Health Matters is a two-volume guide on sexual health issues specific to trans men and women.

PHILADELPHIA (November 15, 2017) – Continuing its commitment to provide the transgender community with high-quality healthcare, Hahnemann University Hospital has launched a Transgender Fellowship Training Program focused on the medical and surgical management of transgender patients. The program is unique in that it is only one of two in the United States, and is the only fellowship training offered at an academic medical center in Philadelphia.

Under the direction of Kathy L. Rumer, DO, FACOS, Hahnemann University Hospital’s Transgender Surgery Program director, the one-year fellowship provides qualified candidates with extensive education and training to become highly skilled transgender surgeons. Fellows will be trained on the practice and principles of transgender surgery and will be involved in all major reconstructive cases, including pre- and post-operative care management of patients.

‘Since beginning at Hahnemann last year, our goal has been to develop a world-class, comprehensive training program focused on training surgeons to become experts in the field of transgender surgery. These are complex procedures, so we want to ensure patients have access to compassionate, capable surgeons who can help make their transitions successful,’ Dr. Rumer explained.

In November 2016, Hahnemann launched a Transgender Surgical Program – a first for an academic medical center in the Philadelphia region and one of only a handful of programs in the country. The surgical program offers a wide-variety of surgical options, including female-to-male and male-to-female gender affirming surgeries, as well as breast, chest and body contouring, and other related procedures.

Since beginning at Hahnemann last year, Dr. Rumer has completed more than 420 transgender surgeries. This figure includes MTF gender reassignment surgery, FTM Top Surgery, and a number of other gender affirmation surgeries.

‘Hahnemann University Hospital prides itself on being a pioneer in medical research and advancement. Creating a Transgender Fellowship Training Program is the next chapter in continuing a legacy of excellence,’ said Michael P. Halter, FACHE, Hahnemann University Hospital CEO.

To enroll in the fellowship, qualified candidates are required to complete an ACGME-approved urological surgery or plastic surgery residency.

For more information about the Transgender Fellowship Training Program, please call Hahnemann University Hospital’s fellowship coordinator at 215-762-7171.

About Hahnemann University Hospital

Hahnemann University Hospital is a 496-bed academic medical center at Broad and Vine Streets in Philadelphia. Hahnemann has been named a Best Regional Hospital in U.S. News & World Report’s 2017-2018 Best Hospitals rankings. An affiliate of Drexel University College of Medicine, Hahnemann University Hospital is part of Tenet Pennsylvania, which also includes St. Christopher’s Hospital for Children.

The guidelines were drafted by an APA task force in the wake of an APA survey in 2009 that found less than 30 percent of psychologist and graduate student respondents were familiar with the issues that transgender and gender nonconforming people face.

The document lays out 16 guidelines aimed at helping professionals better understand the lifespan development, stigma, discrimination and barriers to care faced by this population, as well as the state of research surrounding transgender and gender-nonconforming people.

Members of the APA Task Force on Guidelines for Psychological Practice with Transgender and Gender Nonconforming People were:

• lore m. dickey, PhD, Louisiana Tech University, co-chair
• Anneliese A. Singh, PhD, University of Georgia, co-chair
• Walter O. Bockting, PhD, Columbia University
• Sand Chang, PhD, independent practice
• Kelly Ducheny, PsyD, Howard Brown Health Center
• Laura Edwards-Leeper, PhD, Pacific University
• Randall D. Ehrbar, PsyD, Whitman-Walker Health
• Max Fuentes Fuhrmann, PhD, independent practice
• Michael L. Hendricks, PhD, Washington Psychological Health Center, P.C.
• Ellen Magalhaes, PhD, Nova Southeastern University and Alliant International University

A copy of the guidelines can be found online (PDF, 819KB).

The Fenway Institute has released a guide for providers titled Cervical Cancer Screening for Patients on the Female-To-Male Spectrum: A Narrative Review and Guide for Clinicians.

“This publication gives clinicians guidance on how to provide comprehensive, sensitive gynecological care for people on the FTM spectrum,” explained Dr. Jennifer Potter, Director of Women’s Health at Fenway. “We know from previous work that there is a huge need for this, particularly in the area of cervical cancer.”

Transgender or gender-variant people are often reluctant to access reproductive health screenings, because these screenings may be conducted in an insensitive manner, Dr. Potter noted. Fearing transphobia in the doctor’s office, many transmasculine people choose to avoid preventative, potentially life-saving physical examinations.

The problem is two-sided, Dr. Potter said, as providers frequently have misperceptions about the need for reproductive health screenings for transmasculine patients, especially those who possess natal organs such as a cervix, uterus, or ovaries.

Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians
Original Article: Pardee, Dana J. | Agénor, Madina | Peitzmeier, Sarah M. | Potter, Jennifer | Reisner, Sari L. | Bernstein, Ida | Alizaga, Natalie M.
July 2015, DOI: 1525-1497,10.1007/s11606-015-3462-8

Read more from Fenway Health »
Also see 3 Guides For Doctors: Providing Paps to Trans Men

This document is intended to assist practitioners in providing hormone therapy and primary health care for trans clients. It summarizes the current clinical practice at Sherbourne Health Centre in Toronto, and provides guidance with regard to common dosages of hormones, monitoring strategies as well as references and resources for further learning and support.

This resource is available as a Free PDF Download.

“Educate yourself and treat us like the humans we are. This is a hard road we are traveling and something vital like healthcare shouldn’t be such an obstacle for us.” – Trans man

If You Have It, Check It: Overcoming Barriers to Cervical Cancer Screening with Patients on the Female-to-Male Transgender Spectrum

This guide from the National LGBT Health Education Center covers:

• Identifying risk factors and prevention strategies for cervical cancer
• Identifying barriers to achieving optimal prevention/screening rates
• Identifying strategies that providers can use to address these systems, interpersonal, and technical barriers, including specific techniques for adjusting the Pap exam
• Committing to one change you will implement in your practice to improve care

Download PDF

Guys Get Pap Tests Too: Developing Cervical Cancer Screening Outreach Materials for Female-to-Male Transgender Patients

This poster from Fenway Health explores trans mens’ attitudes towards and barriers to cervical cancer screening and developing novel cervical cancer screening and outreach materials for FTM patients.

Download PDF

Tips for Providing Paps to Trans Men

Intimate procedures that examine or expose the genitals can be particularly challenging or uncomfortable for trans men. This guide from the Check It Out Guys campaign highlights 13 things that healthcare providers can do to make the experience easier.

Download PDF

Also see: 8 Tips For Making Pelvic Exams Easier For Transgender Men

Letters For My Sisters: Transitional Wisdom In Retrospect is a groundbreaking anthology from Transgress Press that features intimate letters written by 35 trans women to their past selves or other trans women. The letters include advice, reassurances, warnings and wisdom, resulting in a collection of revealing stories of childhood, transitioning, and becoming women.

Edited by engineer Deanne Thornton and film producer and activist Andrea James, Letters For My Sisters includes letters written by well-known trans women such as Calpernia Addams, Lynn Conway and Jennifer Finney Boylan, as well as emerging voices like Gina White and Mazikeen Wagner.

“Finally a great little gem of a book by some amazing and talented ladies! Transitional Wisdom is chocked full of short letters to our former selves. There is some thing for everyone -transition or not -either pre or post. Honest and unabashed.” – CJ

“Letters for My Sisters is a wonderful collection of inspiring letters of true courage and strength. It is a great read that will leave the reader full of positivity and a deep understanding of what it entails to be a transsexual women.” – Tacy Chambers

Available in paperback (146 pages) and Kindle.

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Also from Transgress Press: Letters for My Brothers: Transitional Wisdom In Retrospect

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Authored by the pioneering FFS Surgeon, Dr. Douglas Ousterhout and updated by Dr. Jordan Deschamps-Braly, Facial Feminization Surgery covers all forms of plastic surgery that reshape and feminize facial features:

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Facial Feminization Surgery is informative and well illustrated, and clearly outlines what one can expect with Facial Feminization Surgery. The thorough information and stunning FFS before and after photos will help you make decisions about which FFS procedures you might like to have.

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