Transgender medical knowledge among regional GPs in short supply

Posted September 25, 2017 08:20:06

When Holly Conroy first tried to transition from male to female 11 years ago she was talked out of it by family and friends.

“People told me I’d never pull it off as a woman, that I’d never hold down a job, and I can remember my mum saying that if I was ever going to come around I’d have to call first in case they had visitors,” Ms Conroy said.

“There were just so many negative comments.

“I believed what they were telling me. I believed I’d have no friends and have to miss out on family gatherings. And all I’ve ever wanted is to fit in.

“I thought the only way was to live life how people expected me to live.”

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Ms Conroy went on living as David, even getting married, until she hit rock bottom 18 months ago.

She was suffering from chronic depression and a debilitating drug addiction.

Ms Conroy knew transitioning was the answer.

“I decided that I was going to live my life on my terms,” she said.

“We only get one shot at it, so why not live how you want to live and how you feel you should live?”

Tossed in the too-hard basket

Frustratingly for Ms Conroy though, she had a hard time finding the medical services she needed in her hometown of Wagga Wagga in south-west New South Wales.

“When I went to see the doctors here in Wagga they basically shrugged their shoulders and put it in the too-hard basket,” she said.

“They asked me what I wanted them to do. All I could think was that I’d come to them for help — not the other way around.

“It frustrated me to no end and it needs to change.”

Holly’s experience is not unique, as transgender people living in regional areas are having to travel hundreds of kilometres to find specialists who can help.

It is often after they have been turned away by doctors closer to come.

Dr Nick Hamilton is based in Canberra and has around 100 transgender patients, including Holly, and said services Australia-wide are severely deficient — especially in country areas.

“I’ve had patients travelling from up to eight hours away to see me just for an initial consultation,” Dr Hamilton said.

“Most people who have travelled to see me have seen their usual GP and been told it’s not something they’re confident or comfortable helping them with.

“Quite a few patients have seen up to four GPs and a couple of psychologists before seeing me, too.”

The reason rural and regional GPs are passing the buck, Dr Hamilton said, is because they have not had the necessary training.

“I think it’s always difficult to expect rural GPs to know everything about everything and gender medicine is still a fairly niche area,” he said.

“It’s also just not part of a lot of doctors’ previous experience and exposure.

“It’s not something that’s taught in medical schools or commonly practiced in our job so I think that’s what puts some doctors off doing it.

“They just don’t know what to do and don’t feel confident doing it.”

Regional doctors must refresh skills

Bastian Seidel, president of the Royal Australian College of General Practitioners, is also concerned about the knowledge gaps that rural and regional doctors are demonstrating with regard to transgender medicine — especially given the increasing demand for it.

“We’re concerned about this because we want all patients to feel comfortable when they’re seeing their GP,” the Tasmanian-based Mr Seidel said.

“Discrimination is just not acceptable in the 21st century.”

He said doctors who do not feel confident administering transgender medicine need to take advantage of the extensive array of resources available to them.

“Transgender medicine should be mainstream,” he said.

“Transgender patients don’t want to be outsourced to a specialist who may not even live in the same area they’re living in.”

“It’s up to the doctor to educate themselves, which is actually very easy for them to do nowadays.

“Online resources are certainly the most accessible resources and they can be accessed by any health practitioner, regardless of their location.”

Since finding the help she needed, Holly’s life has transformed for the better.

“Life has become so amazing. I just consider myself extremely lucky and privileged to be able to live the life I’m now living,” she said.

Topics: sexuality, sexual-health, doctors-and-medical-professionals, wagga-wagga-2650, canberra-2600, hobart-7000