Israel LGBTQ+ Medical Society launches course on transgender-friendly protocols

 25 family physicians learn how to help trans patients at the first-ever workshop in Israel; endocrinologist expert says wait for hormone treatments can be cut by months

By DIANA BLETTER  

When Y. J. Chichester Salant, a 27-year-old trans woman, went to an ENT doctor in Tel Aviv because of a serious upper respiratory infection, one of the first questions the doctor asked was about her “bottom surgery.”

Salant, the health care coordinator at the Trans Center in Tel Aviv, was taken aback and told him that his question had no clinical relevance to her medical condition. She said that her experience illustrates the difficulties faced by transgender people seeking health care in Israel.

“When ignorance, bias, or transphobia enters the picture,” Salant said, “going to a doctor can be a very traumatic experience.”

To address some of the healthcare issues facing the transgender community, Dr. Roy Zucker, the chairman of the Israel LGBTQ+ Medical Society, and Dr. Shimrit Arbel, head of the facial gender confirmation surgery clinic at the Tel Aviv Medical Center, organized the first-ever course on the subject in Israel.

The Transgender Care Training Program for Family Physicians ran for three days in June. Arbel said it was designed to give the 25 attending family physicians “practical tools to enhance the care they provide to the transgender community.”

Zucker said that 80 family physicians applied for the course; organizers selected physicians from each of the four health maintenance organizations (HMOs) nationwide, including from the peripheral areas of north and south. A physician working in the Arab community in Jaffa and one working in the Orthodox Jewish community in Jerusalem also attended. In those societies, Zucker said, it’s much more challenging for transgender individuals to seek medical help.

The course was sponsored by the Jewish LGBTQ Donor Network, the Israel Medical Association, the Tel Aviv Medical Center, and the Gila Project, an organization that advocates for transgender healthcare rights.

A broad swath of experts, including psychiatrists, surgeons, doctors, and representatives of organizations spoke about mental health issues, pre- and postoperative hormone therapy, gender dysphoria, and surgical options for the transgender population.

Zucker said that over the past few years, the number of transgender patients seeking hormone therapy has increased significantly. But there are only three endocrinologists who specialize in treating the transgender community, all of whom are located in the center of the country. There is a wait of about six to eight months for appointments.

By training primary care physicians in transgender hormone treatment, Zucker said, waiting time can be cut by at least six months.

Dr. Joshua Safer, head of the Center for Transgender Medicine and Surgery at Mt. Sinai Hospital in New York, gave a workshop on hormonal therapy so that primary care physicians are equipped to treat the community, he told The Times of Israel.

After an initial consultation with an endocrinologist, transgender patients can turn to their primary care physician to continue hormone treatments.

Illustrative: Rabbi Tsipi Gabai blesses Tom Chai Sosnik, a transgender teenage boy, as his parents and sister look on at Tehiyah Day School, El Cerrito, California, March 13, 2015. (Misha Bruk, BrukStudios.com)

“Hormone treatments for the transgender population might be more complicated than treating people with a thyroid condition,” Safer said. “But it is less complicated than treating diabetes.”

To visit her Herzliya clinic, which she opened in 2022, patients don’t need a referral from their primary care physician, nor do they pay an additional fee. Lankry also provides health care by telephone to people around the country.

Lankry became interested in helping the community when her brother, who is transgender, told her about how difficult it was for him to receive good health care.

“Trans people feel they’re all alone, with nobody to consult with,” Lankry said. “Physicians who understand them are like water in the desert.”

Dr. Roy Zucker and Dr. Shimrit Arbel, organizers of the Transgender Car Training Program for Family Physicians (Courtesy)

Across Israel, 40 percent of the transgender population has attempted suicide, according to a 2020 Health Ministry report.

Transgender individuals often feel they’re not able to integrate into society, Arbel said, thinking that “people look at them differently and judge them by their appearance.”

At the course, she spoke about facial feminization and masculinization surgeries that “help people align their facial characteristics with what they feel their gender is.”

One of the goals of the course was to create a task force to continue working on ways to improve medical treatment for the transgender population, Arbel said.

Salant, who plans to go to medical school to focus on children and adolescents with neuro-developmental disabilities, led a panel in creating a transgender-friendly medical practice. She said it was important to have someone speak at the course who worked in the trans community and could add her perspective.

“The course was one of the first major steps in getting to a place where services for transgenders are more accessible in different parts of the country,” Salant said.

Courtesy: New Indian Express

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