LGBTQIA+ persons face significant health disparities in multiple areas. For the transgender population in particular, medical interventions like hormone therapy or surgery pose an additional barrier, and they often lack access to care.
“A lot of people in marginalized groups avoid or are denied access to primary care,” said Jamie Feldman, MD, PhD (she/her), a family medicine physician who specializes in gender and sexual health at University of Minnesota Physicians (M Physicians). “So, I’m also a bridge for that. Patients may see me for one thing, and I can help them access primary care if they need it.”
Dr. Feldman practices primary care at the M Health Fairview Women’s Clinic, a multidisciplinary practice where she provides inclusive care for the LGBTQIA+ patients in her primary care practice. She spends most of her time at the M Health Fairview Center for Sexual Health, the clinical arm of the Institute for Sexual and Gender Health, where she specializes in sexual health and gender-affirming care for patients of all ages and identities.
The M Health Fairview Comprehensive Gender Care Program is a coordinated, multidisciplinary network providing gender affirming services, including surgery, OB/GYN, primary care, mental health, hormone therapy, and more. The program starts with care coordination to help patients connect with the services they need. This can include healthcare providers trained in sexual and gender healthcare who can address sexual health concerns, sexual dysfunction, gender identity and affirming interventions, including but not limited to hormone therapy, reproductive options, surgeries, and if medically needed, puberty suppression for adolescents.
“Therapists work with patients and families, helping them explore gender while also providing medical education,” Dr. Feldman explained. “They’re supportive along a gender journey in a world that can be stigmatizing.”
Studies suggest that transgender children who receive gender-affirming interventions earlier in life experience improved mental health outcomes and are less likely to experience suicidal thoughts as adults. With some states looking to ban or limit these interventions, Dr. Feldman hopes M Physicians can expand capacity for patients and families who may have to cross state lines to receive care.
“We know physical and mental health, and to some extent survival, increase if we are able to help people reach their gender affirming interventions earlier – no matter what those interventions are – as long as they’re appropriate for the person,” Dr. Feldman said. “If people know these services are out there and can access them, they save lives, they save physical and mental health.”
Dr. Feldman’s unique expertise draws patients from across the upper Midwest, since many areas lack access to LGBTQIA+ centric care. On an initial visit, patients can expect a tailored informational session and open discussion of any questions or concerns they may have, even before anything medical takes place.
“It’s an uncommon program,” Dr. Feldman said. “While in some areas of the country there are a lot of providers focused on LGBTQIA+ health, that’s not the case in most of the country.”
The Institute for Sexual and Gender Health is involved in advocacy and research aimed at improving access and outcomes for the LGBTQIA+ community. This includes research looking at the trajectory of adolescent gender exploration and how this might change over a lifetime, as well as examination of data comparing transgender health conditions, access to care and tendency to postpone care.
“While transgender and cisgender populations had equally high levels of insurance, transgender folks were much more likely to postpone care due to costs,” Dr. Feldman explained. “Research suggests that the transgender community experiences a higher level of poverty and has a very unique set of health barriers and problems, even if their insurance is just as good. So, there are some particular issues they face that we need to look at more closely.”
Through this research, she hopes to better understand what these financial and health barriers include and how to better address them. This unique fusion of clinical excellence, research and advocacy aims to bring compassionate, patient-focused care to the LGBTQIA+ community.
“M Health Fairview has a great deal of potential to provide excellent primary and specialty care across the sexual and gender spectrum,” Dr. Feldman said. “There are many wonderful physicians that go out of their way to be educated, knowledgeable and are willing to learn and meet your needs.”
M Health Fairview Center for Sexual Health
West Bank Office Building, Suite 180
1300 2nd Street S, Minneapolis, MN 55455
M Health Fairview Women’s Clinic
Riverside Professional Building, Floor 3, Suite 300
606 24th Ave. S, Minneapolis, MN 55454