GYN Brochure

Transgendered females were born with female biology, yet their own identity, their sense of self is not as a woman. If they still have female reproductive organs, they have the same female physical problems, illnesses and conditions that females who identify as women do. But there are differences that can make it difficult for Transgendered females to get the GYN care they need.

The terms man and women are often used interchangeable with male and female. Male and female are sexes - the physical body. Man & woman refer to gender - a feeling inside as well as an expression outwardly. We live in a dual gender world of men and women. Yet, there are more gender expressions than that. Transgendered females are born biological females, yet exhibit looks, style, mannerisms and activities that would be considered masculine or "manly" by the mainstream. Many actually do pass as men a lot of the time and many live their lives as the men that they feel they are internally. Some do not feel like women, yet they do not feel like men either. They may identify as "other" gendered. Some may be Transsexual and may take testosterone to achive a masculine appearance but still have female reproductive organs and genitalia.

Some masculine females identify as "Stone Butches" or TG (transgender) Butch and do not like to be treated in any way like a woman, including sexually. A GYN exam is very difficult for these individuals because it feels "too female" to them, which for them, is not a natural feeling. This body dysphoria and feeling of discomfort with their female organs may keep them from getting regular gynecological health care. Many do not like penetration or to even be touched genitally at all. So they avoid gynecological care because it involves those female body parts that they are not comfortable with.

Also, most gynecologists do not understand about masculine female identities and it becomes a daunting task to explain all of this in a health care setting where there can be fear of alienating the health care provider or that personal judgments may be made. The best thing would be if the health care provider routinely asked if penetration is a problem and if the patient prefers quiet or reassurances during the exam. It is also helpful if their partner or a friend is allowed to be with the Trans person during the exam. The important key is letting the patient be the guide for their comfort level.

Some transgendered females are transsexual and identify as Transmen, FtM (female to male) and identify and live as men. Many FtMs desire to create a more male looking body and take testosterone (T) and have surgery to create a male looking chest or create male looking sex organs. Others only take T and may have chest reconstruction. Others will not take T or have surgery. They may or may not still have all their female reproductive organs though it is a good bet if they are contacting a gynecologist, they still have a beed for gynecological care.

A gynecologist may encounter an FtM patient who has the secondary sex characteristics of a man, such as a beard or balding due to taking testosterone, but who still has a vagina and ovaries or breasts that they bind flat. Sensitivity is key in dealing with Trans patients. They need to be made comfortable and welcomed by the staff and for staff to treat them how they want to be treated. This includes using the proper pronoun for the patient. If you are not sure, ask the patient if they prefer "he" or "she". If the staff is educated and treats them with calm matter-of-fact respect, it will set the tone for other patients who also may be there waiting for their appointments and wondering why there is a man in the waiting room and goes in to see the doctor alone. Staff should NEVER discuss gender or identity of Trans patients with anyone in the waiting room. It may also help to arrange an appointment during slower times of the day if possible. Ideally, the last appointment of the day may be best for many patients. As always, let the patient be the guide as to their own confort levels.

If you can provide an atmosphere of dignity and respect for your transgendered Butch or FtM patients and you do not make assumptions that become hard for them to respond to, they will be more likely to take care of their female body parts on a regular basis. Don't be afraid to ask questions and to make it clear you respect patients of all genders. Not all Butches and FtMs live in urban areas to be able to go to gay & lesbian health care providers. Many, if not most, will need small private gynecologists and health care professionals to provide caring, respectful treatment.

As a gynecolgist or other health care provider, it is important to remain non-judgemental and to provide the optimal atmosphere for all your patients. Cancer and other ailments don't care about a person's gender identity. Access to health care and getting appropriate health care is important for all people, regardless of how they identify.