The Transgender Patient’s Healthcare Dilemma: Scarcity of Physicians with Gender Identity Expertise

Saturday, May 17, 2014 5:15 pm EDT


"We have all of these hormone regimens and already use them for other purposes and most of this treatment is quite straightforward"

LAS VEGAS--(BUSINESS WIRE)--Citing a lack of knowledgeable care providers, misunderstanding of causal factors and the influences of societal stigma, a prominent Boston University endocrinologist advocated for the introduction of a standard transgender curriculum at all North American medical schools today at the American Association of Clinical Endocrinologists’ (AACE) 23rd Annual Scientific and Clinical Congress in Las Vegas.

Dr. Joshua D. Safer, F.A.C.P., Associate Professor of Medicine and Molecular Medicine and Director of the Endocrinology Fellowship Training Program at the Boston University School of Medicine, is one of only a handful of endocrinologists across the nation who specialize in treating transgender individuals, people who are born with typical male or female anatomies but feel as though they’ve been born into the “wrong body” and self-identify as the opposite sex.

“Based on surveys, transgender patients report a lack of ability to find a provider who either know the topic, or is sensitive to their medical needs, and that is the biggest barrier to care,” Safer notes. “In my experience, while well-intentioned, few physicians currently in practice know anything about how to treat a transgender patient. It’s a massive gap that needs to be addressed.”

“Physicians mistakenly believe that transgender is a reversible psychological condition best managed with psychiatric intervention when, in fact, available data suggest otherwise,” he continued. “People don’t recognize that gender identity is a biologic phenomenon.”

There are several studies that point to the “hard-wired” nature of gender identity as evidence, Safer asserts.

“Once the permanent nature of the condition is recognized as a ‘fixed’ thing and you process the logic, the required treatment regimens and monitoring are quite straightforward for endocrinologists who have expertise in hormone treatment,” he added.

Safer suggests that once a transgender diagnosis has been confirmed by the patient’s medical team, treatment can commence in a “sober fashion” and typically consists of cross-sex hormone administration and reconstructive surgery.

“We have all of these hormone regimens and already use them for other purposes and most of this treatment is quite straightforward,” he says. “It’s not as though we had to create a new hormone, so it’s a matter of knowing what works.

“I’m very mindful of how little time is available for more training, but the convenient truth is that the transgender curriculum we currently teach at Boston University is very modest and would fit very easily into a training schedule at all medical schools,” Safer concludes. “This is what I am advocating, and I intend to be successful.”

To read additional press releases about the AACE 23nd Annual Scientific and Clinical Congress in Las Vegas, please visit or use the Twitter hashtag #AACE14.

For a brief bio and photo of Dr. Safer, please click here.

About the American Association of Clinical Endocrinologists (AACE)

The American Association of Clinical Endocrinologists (AACE) represents more than 6,500 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. The majority of AACE members are certified in endocrinology, diabetes and metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at

About the American College of Endocrinology (ACE)

The American College of Endocrinology (ACE) is the educational and scientific arm of the American Association of Clinical Endocrinologists (AACE). ACE is the leader in advancing the care and prevention of endocrine and metabolic disorders by providing professional education and reliable public health information; recognizing excellence in education, research and service; promoting clinical research and defining the future of clinical endocrinology. For more information, please visit


Mary Green, 407-506-2960