Rotation Description

This course is a 2- or 4-week immersive clinical experience for urban health residents who want to learn more about the care of transgender and gender diverse patients. Learners will rotate through different specialties and work with clinicians involved in various dimensions of gender-affirming care. There is an emphasis on primary care, although residents will have the opportunity to see surgical patients in clinic and in the operating room, observe a thorough mental health assessment, and meet with members of administrative staff for the Johns Hopkins Center for Transgender and Gender Expansive Health.

In primary care, there will be a stepwise approach to patient care. Learners will begin by seeing patients together with the clinician and move gradually towards independent practice over the course of the rotation. Appointments with transgender patients are integrated into the overall clinic schedule, so not every primary care patient seen during the course of the rotation will be transgender. At the discretion of the course director, the learner may be assigned other tasks related to gender-affirming primary care instead of seeing cisgender patients - for example, reviewing hormone test results and adjusting hormone regimens with supervision.

Goals & Objectives

Goal: To familiarize residents with multiple disciplines involved in the care of transgender patients

Objectives: By the end of the rotation, residents will be able to:

• Demonstrate the ability to respectfully elicit gender identity and goals of gender-affirming care in a patient or mock-patient interaction
• Describe the expected effects of masculinizing and feminizing hormones
• Name the components of a typical masculinizing and feminizing hormone regimen
• Name 3 complications of masculinizing hormones and of feminizing hormones
• List common gender affirmation surgeries
• Describe post-surgical aftercare for gender affirming surgeries, including mastectomy, breast augmentation, phalloplasty, and vaginoplasty.
• Recognize post-surgical complications of gender-affirming surgeries which require a specialist referral

Learner expectations

There will be dedicated time for completion of required online trainings in transgender health and for preparation of an oral presentation. Learners will give a 10-minute oral presentation to the rotation director on one aspect of transgender health. Topic will be mutually selected by learner and rotation director on first day of rotation. Presentation to be given on the last day of the rotation.

Who is eligible?

This elective is available for residents in the Urban Health track. Internal medicine residents may also participate in the elective rotation pending availability.

For more information, contact the rotation director: Helene F. Hedian