Providing Comprehensive Gender-Affirming Care

Providing Comprehensive Gender-Affirming Care

Transgender individuals face a variety of disparities, with serious consequences. Few medical centers in the nation have the expertise to provide these patients with the surgical, endocrine and other care that many desperately need.

That’s why Johns Hopkins launched the Johns Hopkins Center for Transgender Health in the spring of 2017. The center, headed by clinical director Paula Neira and medical director Devin O’Brien Coon, began providing gender-affirming surgeries at The Johns Hopkins Hospital a few months later for the first time in four decades. These surgical services fall primarily within Johns Hopkins’ Department of Plastic and Reconstructive Surgery, with collaboration from experts in other departments as needed.

But gender-affirming surgeries—including vaginoplasty, phalloplasty, mastectomy, breast augmentation, tracheal shaving and facial feminization—aren’t the only care that the center offers, explains Coon. Experts in various other specialties, such as endocrinology, dermatology and mental health, can provide hormonal care, hair removal, assessment of surgical readiness and other services that these patients need.

“It’s still relatively rare to have a center that offers care specifically for transgender patients, and it’s even rarer to have a center that offers coordinated multidisciplinary care,” says Coon. “That’s what our center aims to do.”

The center currently offers its services in a virtual space, with patients referred to specialists throughout the Johns Hopkins system with expertise in transgender health. However, says Neira, she and other providers affiliated with the center plan to eventually have a dedicated space in which patients can see multiple types of providers in a single location at the same visit, making care easier and more efficient for patients.

Performing research will be an important component of the center, Neira says, and involving patients in designing and conducting that research will be crucial as our center evolves.

“It’s not hyperbole to say that providing medically necessary services for the transgender community saves lives,” Neira says. “Through this center, Johns Hopkins is taking a huge step toward addressing this issue.”