Transgender Medicine: FNPs Raissa Behm and Ashley Whatley Talk Inclusivity in Primary Care and Urologic Practice

Speaker 1: 

Welcome back to the Armour men’s health hour with dr. Mystery and Donna Lee. Hello.

Speaker 2: 

Hello, and welcome back to the armaments health hour. I’m dr. Mr. Your host here with my cohost, the wonderful and multitasking.

Speaker 1: 

I hear sarcasm dripping from your lips there, but yes, thank you.

Speaker 2: 

You know, my name is really dr. Mystery. I heard that was a game I S T R Y.

Speaker 1: 

We had a patient swear that it wasn’t his real name. So M I S gimmicky. I don’t know why you’re so serious all the time.

Speaker 2: 

I’d really like to be accused of being informative. That’d be nice. That’d be nice. Once in a while, it would be nice to be, you know, kind of given that you wouldn’t think I would have such a, such a fragile ego, but I don’t know. That’s why you have a giant sports car. No, I do not. I have a very large truck. I mean, I may be trying to make up or something or the large truck that’s right. You know, I think my dad still asks me why I didn’t ever become a heart surgeon. That’s right. Listening to the show. So he does not. I think he, I think this show makes him fall asleep to his friend who listened to it though. Oh, I think I died friends. I am a board certified urologist. This is a men’s health show. We like to talk about a variety of men’s health topics. We have offices all over town. Donna is not only my cohost, but also the office manager here. So when you call our office and have a problem, or want a question answered, or hopefully make an appointment and get treated, sometimes she’ll be one of the people picking up the phone and getting in. Why don’t you tell people a little bit about practice again,

Speaker 1: 

You can reach us during the week at (512) 238-0762. Our website is Armour men’s health.com. We are bringing you the show from urology specialists, and you can email us your questions. We get the most amazing questions and they’re super informative and engaging and very complex to Armour men’s health at GMF.

Speaker 2: 

And they mean a lot to us because, uh, when, when you take the time to listen to the show in the car and go home and get on the computer and email us, or listen to the podcast and send us an email, it really suggests a very high level of engagement and keeps us going. It means that people really appreciate the information that we’re doing.

Speaker 1: 

And we know that lots and lots of men in Austin have erectile dysfunction. Now that’s right, please. No, cause all emailing us

Speaker 2: 

As a urologist, we deal with a variety of very sensitive topics. I thought we would talk about a topic that probably doesn’t get a lot of, kind of airtime on the radio. And that is transgendered medicine. We have our partners from pride, family medicine, uh, Reisa, bane, and Ashley Wadley with us today. Thank you for joining us today. And as a urologist, one of the first times that we come across this idea of gender identity or gender specification is in children who are born with what we call ambiguous genitalia, what an unfortunate way really to have to come into this world with, you know, many times it’s unknown kind of pre-birth, but there can be hormonal abnormalities that occur while you’re developing as a fetus that result in either genitals that don’t appear to be normal or both genitals or either, or, or, or no genitals. That must be something that you’ve come across, uh, in treating children.

Speaker 3: 

Absolutely. Yeah. And not only with, uh, being born with a birth abnormality, I think people don’t understand that gender identity is something that a child has expression of as, even as early as age of four.

Speaker 2: 

Yeah. I’ve heard over the years, multiple different kind of takes on how you should parent there’s people who are against anything, blue and pink. Then your whole house just looks green and yellow, unfortunately. And it’s, it just seems against kind of how we all were raised. I think that some people kind of rail against this, this feeling, but ultimately we just want people to feel comfortable with themselves, right. A hundred percent, right? I mean our jobs as a society and as physicians isn’t to make our patients feel uncomfortable, who they are or to, for them to doubt who they feel they are. And I think that a lot of people with gender identity issues don’t seek medical care. They, they, they don’t want to get looked at. They don’t want to get judged. I don’t know if they’re listening to this radio station or to this podcast, what would be some advice you would give to somebody who’s in that position and, uh, how, how do they seek care that they think they’re going to be comfortable with?

Speaker 3: 

I think a lot of the time, the, uh, word of mouth community from social media or established, uh, LGBT places like out youth or LGBT chamber of commerce kind of clinic kind clinic Ashwell they have resources listed for vetted providers that are inclusive and competent and front end staff has trained eye. So word of mouth is really, really important. And then doing your research because most people don’t go into a provider’s office without doing their research. Um, we really have made the space at our clinic to be as inclusive as we can, and it is different model of medicine and that the providers, we understand that you’re coming to tell us something that we are believing and supporting you and not diagnosing. We’re not saying like, Oh, you have high blood pressure and this is how we treat it. We’re listening to your experience and helping you along that journey. So it is a different dynamic between the patient and the provider. And we really try to be supportive with that.

Speaker 2: 

You know, what’s interesting is that, um, if you were just kind of modeling what a doctor or a healthcare provider should be, you would naturally assume that they would be unbiased. And open-minded you, you know, like if you, if you just, when you kind of make this prototypical doctor in your mind, you’re thinking that that person probably has heard everything, you know, is going to be and how they treat you is going to look at everybody. The same people are people, right? People are people. And so the same biases, same whatever, you know, against the idea of transgendered identity, uh, race, uh, whatever else biased exists in the community or is going to exist to, to some degree in the medical profession. It is completely unacceptable though. I mean, we it’s an unacceptable anywhere, but certainly within the confines of your doctor’s offices is unacceptable. So what are some of the things that somebody who has an identity disorder, whether they transgendered male, transgender, female will come to you for specifically related to that for medical care,

Speaker 3: 

Usually hormone therapy is, um, you know, a lot of the trans community will come in with a dysphoria and, um, we do a lot of their hormone, um, and gender affirming therapy for them

Speaker 2: 

Because they would like their body to look closer to

Speaker 3: 

How we’re trying to help them with congruence. So they come in and the intake process, we allow a lot of time for these visits. So usually our first appointment is 45 minutes. So it’s a lot of in depth history. And, um, if, if there’s any, you know, if hormones, aren’t the direction that they feel like they need to, and that’s not off, you know, it’s not always the case for trans medicine. We can give them all kinds of other social services, resources, or counseling resources. So we just keep, or we vet, you know, medical providers. You’re one of them that we feel comfortable with referrals. If we need some, if there is question about genitalia or surgeries related, so we provide information and we prescribe cross sex hormones, gender affirming hormones, we put them in touch with surgeons. If they’re interested in any surgery that helped them be more aligned, more congruent with who they are.

Speaker 2: 

And whether you individually out there as a listener are particularly in favor of, or, or whatever your feeling is towards the transgender community. I mean, it’s, it’s gonna, it’s gonna, it’s gonna affect you potentially at some point, you’re your own family member, something of that nature. And you’re going to be forced to kind of reckon with that understanding. And, uh, I, what I found interesting is that sometimes I worry about using the wrong word or the vernacular, but I have found members of the transgender community to be very open about kind of helping direct me on how to like, you know, I’m not worried about making a social full pie. I just wanna, you know, what, what do I say to make people comfortable? And I, and I, I feel like that about all people in fact, that, that people know that, that there may be discomforting situations and they’re happy to help you go through it.

Speaker 3: 

Yeah. You just ask me, just ask, what pronounced would you like I lead with, what, how do you want me to refer to your body parts? Do you want me to use terminology? Do

Speaker 1: 

You have your own words? Do you mean try to be like very gender neutral dangling and yummy

Speaker 2: 

[inaudible] for those of you that listen to the show regularly? Um, well, uh, the last point I wanna make is that, um, just like in, in so many instances, just being transgender does not mean that that’s the only thing you are. And so, I mean, ultimately you still need a primary care doctor and you still, you can still get heart attacks and you can still going to get prostate cancer. And you’re still going to get all these other things, um, that can affect your health. You still need vaccinations, you still need all those things. So, uh, having a primary care relationship, uh, is super important for your overall health. And I think your mental health too, I mean, you need to, you need to have somebody that’s going to be on your side. That’s going to be, uh, you know, and know how to take care of you. So, uh, thank you so much for the work that you guys do. Uh, if somebody is interested in getting taken care of by you, how do they get ahold of you?

Speaker 1: 

So you can reach us@pridefamilymedicine.com. That’s our website, or you can call the clinic at (512) 379-7272. Well, that’s an easy one. We can get an easy one.

Speaker 2: 

Well, no, we can’t change her phone number now, rice on Ashley. Thank you so much for joining us and thanks for being a great partner of ours.

Speaker 1: 

Oh. So he can call us during the week at (512) 238-0762 and send your emails to armor men’s health@gmail.com or through the website at our men’s health.com. That was awesome. Thank you guys so much for being here. Thank you, gals. We appreciate you. Dr. Mystery wants to hear from you email questions to armor men’s health@gmail.com. We’ll be right back with the armor men’s health hour.