A GP's perspective

A report back on Teddy Cook and Shoshana Rosenberg’s presentation, ‘The inaugural Australian Trans and Gender Diverse Sexual Health Survey: Barriers, Resilience, and the Impact of Trans-Led Research’ 

I was delighted to see trans sexual health included in the opening plenary of the ASHM Sexual Health conference this year. Teddy Cook (Manager, Trans & Gender Diverse Health Equity, ACON) and Shoshana Rosenberg (University Associate, Curtin University) presented the findings from the largest ever Australian sexual health survey relating specifically to the trans and gender diverse (TGD) community. 

Participants were recruited on-line over a 3 week period in late 2018, with 1613 eligible participants completing the survey. 

The results are important, shocking, but perhaps not surprising.  

Over half (51.2%) of participants reported experiencing insensitive sexual health care. Participants were less likely to attend for sexual health testing if they had experienced previous gender insensitivity. Only 51.5% of participants reported having a previous HIV test. Transmen commonly reported inconsistent condom use, however only 2.2% were accessing PrEP. Over half (53.2%) of participants reported experiencing sexual violence or coercion.  

GPs are usually the first “port of call” for gender diverse clients accessing health care. In this survey most participants (72.3%) received sexual health care in a general practice setting. 

I sit uncomfortably in my chair as I reflect on this. I think about the lack of training in trans and gender diverse health at medical school, general practice training and other specialist training programs.  

And then I reflect on our role as GPs, to provide holistic, patient-centred care. To create a safe space, listen, and elicit the patient’s ideas, concerns and expectations. To develop respectful and trusting relationships with our patients. To help people navigate the health system. Showing humanity. Providing information and allowing our patients to make informed decisions about their care and their bodies. 

My attention goes back to the small group of passionate and dedicated community members, volunteering their time yet again, patiently explaining the issues that impact on them and their peers. I watch them present high-quality data, appeal for funding, cis “allies”, trans-led research, trans advisory groups, inclusion, visibility, and meaningful policy change.  

We need to step up and advocate for our trans and gender diverse patients, particularly during the current wave of transphobia that is sweeping across Australia.  We need to learn what we need to learn, provide inclusive welcoming practices, and do so quickly before more lives are lost. Trans and gender-diverse people should be able to visit a GP anywhere in Australia and access sensitive sexual health care, and gender affirming care. I hope in the future we will see a day when trans and gender diverse clients can look forward to a visit to their GP. 


     Author bio: Pauline is a GP and Medical Educator based in Darwin.