The Twin Cities is home to a program that provides transformative care for transgender and gender nonconforming patients during all stages of their transition.
The M Health Fairview Comprehensive Gender Care program, established in 2018, is designed to help reduce the significant health disparities and barriers that transgender and gender nonconforming people face by providing patients with access to a full spectrum of medical knowledge. The program has roots dating back to the 1970s, when the University of Minnesota Medical School created a gender care service within its Program in Human Sexuality.
“It is about bringing all of these different specialties that don’t normally function in the same clinic space together and coordinating care for patients that need multiple providers,” said Dermatologist Matthew Mansh, MD, FAAD.
Mansh is one of a handful of surgeons, dermatologists, psychologists, care coordinators and other specialists affiliated with M Health Fairview and University of Minnesota Physicians, all of whom work diligently to ensure that each patient in the Gender Care program has a positive experience.
That full-spectrum care is often coordinated by Ejay Jack, MSW, MPA, who serves as the lead care coordinator and community liaison for the Comprehensive Gender Care program. As a member of the transgender community and one of the program founders, Ejay connects one on one with patients to help them navigate the many processes, appointments, and procedures that may be part of each individual journey.
“One of the barriers in the past was not having all of the key players together,” Jack said. “Coordinating between all of these providers has become easier now that we have a centralized system.”
To illustrate the complexity and need for coordination, Jack shared an example. A patient may see a mental health professional, Jack said, who then refers them to another provider for hormone therapy. During hormone therapy, that same patient may start developing acne from testosterone or may need laser hair removal. This may require another referral to a dermatologist. Because of the complexity, Jack helps manage appointments, the timeline, and planning for additional procedures.
Over time, the program has grown to incorporate an even more diverse array of specialists, such Plastic Surgeon Nicholas Kim, MD. Kim went into plastic surgery because of its functional approach – reconstruction often helps people regain function. Kim augmented his surgical skills by training in Ghent, Belgium, with internationally renowned gender care experts.
Craniofacial Surgeon Sun Hsieh, MD, has a similar story. He completed a specialized training program in Spain with FACIALTEAM, where he learned from a group of surgeons who are leading the way in facial gender confirmation surgery,
“I like working with populations where you can make a huge impact on their lives as a whole,” Hsieh said. “I stepped into a very fortunate situation at the University of Minnesota. A lot of the personnel coordination was already working really well."
Urologist Joseph Pariser, MD, also joined the Gender Care program to make a difference for transgender and gender nonconforming people. Pariser worked with the transgender community during his medical training and now regularly collaborates with Kim to complete surgical plans.
“I enjoyed having a connection with patients and doing the unique, creative surgeries that are really impacting their lives,” Pariser said. “More and more urologists are working on this, and there’s more collaboration between urologists to share knowledge. Surgeries are being more standardized and the cutting-edge stuff is becoming more common.”
“I think gender care will become increasingly important for all physicians in the future,” said Mansh. “I see over 100 patients a week normally, and even from epidemiology it shows that you’re going to be seeing these patients more often, so being comfortable providing care from the medical and surgical standpoint is important.”