AMAA : Ask an LGBTQIA+ friendly GP

Hey I’m an unsupported trans boy and I was just wondering if you had any tips on where I can get support?

"I am very happy to say that there are lots of organisations that provide information and support! Without knowing where you are from I cannot be as specific as I would like, however organisations like ReachOut and Transcend Australia are national organisations that can help point you in the right direction. Transcend has a list of organisations in each state that may help!

It is also really important to have a strong peer network -  other trans and gender diverse people who understand what you're going through in a way that even well meaning cis friends and family may not. 

If you have a GP you trust, they can be a very helpful resource as well."

If you're looking to chat to other trans and gender diverse people - our online community is a great place to start! Read or post about gender here 😊 You can also read our articles on gender here.

What would it take to get more queer friendly doctors like yourself out there in the open? 

"That is an excellent question, and one I think about a lot! I have always considered myself a queer friendly GP and have always had many patients that were queer, but until 12 months ago I did not "advertise" myself as such. It is now written on my bio on my website, and I definitely encourage other queer friendly GPs I know to write it as well! Unless someone directly states they are queer friendly it is hard to know, and I know that for some people choosing a random GP to discuss their sexuality or gender with can be very scary. 

For GPs, medical specialists, and allied health who specifically work in the gender space, there is a list on Auspath.

Otherwise, you can try looking at GP bios on their website, or calling a clinic to ask. However, finding a GP who is queer friendly is often based on word of mouth."

What makes a GP queer friendly and how would you know if they are? Don't all doctors just see people as people and healthcare workers have a legal responsibility to treat everyone fairly and with respect?

"I think that what makes a GP queer friendly is best answered by the patient, and not the GP! However in my experience, a queer friendly GP should not just treat you fairly and with respect - which as you say, is the absolute bare minimum. They should  also provide a safe and inclusive space, use inclusive language, and make no assumptions of gender or sexuality - instead asking in a non intrusive and non judgemental way.

They should also be well informed about issues specific to queer people - or at least know where to seek information if they are unsure.

Ideally, the clinic as a whole would also be queer friendly  - e.g. have an inclusive new patient registration form, and have staff that are also well informed -- specific LGBTQIA+ GP clinics are very good at this, however not every standard GP clinic does this as well as they could.

In regards to your point that everyone should be treated fairly and with respect - I absolutely agree. However we know that not every medical professional is as well educated in this space as they should be, and although they may not be outwardly disrespectful, may use incorrect language or tone that would not make them what I would consider queer friendly.

If someone is ever so unsafe that it is clear that they have prejudice against queer people - I would strongly encourage a formal complaint to the clinic/employer, and escalating further if you do not feel that it has been handled appropriately by the clinic."

I’m a gay man, and I’m too nervous to ask my doctor about prep. Plus I don’t know much about it or how to get it.

"PrEP (Pre-exposure prophylaxis)  is an effective medication to help prevent HIV infection in people who are at risk of HIV contraction through condomless intercourse. This may include gay men such as yourself, but  also includes transgender men and women, and cis women with a HIV positive partner or a partner who is a higher risk person.

Thankfully, PrEP is now very easy to prescribe! Any doctor can do it. 

It does require regular STI tests and blood tests every 3 months prior to each script, but there are very simple guidelines your doctor can use - if they are unaware you can let them know of a very simple flowchart found at ashm.org.au that they can read up on prior - or if you are not comfortable discussing with your usual GP you can seek out a LGBTQIA+ friendly GP who will hopefully already be aware of the guidelines.

It is still of course recommended to use condoms regardless of whether you are taking PrEP, as PrEP does not protect against other STIs."

You can check out our guide to safe sex here, and read more about HIV prevention over on ACON's website. 

"I'm going to make an assumption based on your question that you are a ciswoman -  Apologies if I am incorrect!

If you are currently using a form of contraception other than condoms, this of course does not need to be continued if you are in a monogamous relationship with someone with a vagina. However for most forms of contraception, stopping and starting it is not recommended, so if you are possibly going to also be having sex with someone with a penis, it is recommended to continue your contraception.

However we of course know that safe sex is not just about preventing pregnancy! Other things to consider is using condoms for toys, and you can consider using a dental dam. It is still important to have STI checks, as many can be spread through use of toys, oral sex, or skin to skin contact.

Playsafe has a quick read from the NSW government on safe sex between two people with vaginas."

I’m a lesbian do I still have to get pap smears? 

"Absolutely! HPV is the virus that causes cervical cancer, and this can be spread through many forms of sexual contact, including oral sex, genital to genital contact, and even sharing of toys. It is still important, regardless of type of sex you have."

You can find out more about how to get a sexual health check and pap smear here.

"This is a tricky question to answer as it depends on the context! It varies whether you are talking about hormonal therapy for gender affirming healthcare, contraception, or other hormonal deficiencies. Side effects and experiences of the hormones can vary widely depending on whether they are feminising hormones (oestrogen, progesterone) or masculinising (testosterone), and the dose. I recommend you talk to a GP or healthcare provider that works in this space to discuss further."

Transhub have some really great information about hormones that you might like to have a look at too 😊

"This is a very personal experience and I'm definitely not able to tell you how it is going to be most comfortable for you! However there are a few approaches - next time they assume something (e.g. if they are making comments about needing contraception but you are same-sex attracted), you could gently correct them and explain why.

Or you can just go for the blunt approach and at the end of the consult just slip in a "by the way I'm gay, see you next time!".

Another less confronting option is asking a family member next time they see the doctor to tell him, if you are out to your family.

Of course unless it is medically relevant, you do not HAVE to tell your doctor. Although I hope you have a good enough relationship with your doctor that you are able to be open with them, and if they react in any way other than purely supportive, it might be time to find a new doctor."

"I'm sad to say that it can be very expensive. It is not available in the public system as yet, so the fees can vary widely depending on the surgeon and hospital. You currently also need a WPATH assessment prior to surgery, which can add to the cost.

Transhub quote it as being $4000-$18,000 out of pocket depending on the technique and surgeon."

You might also like to look into binding, if top surgery isn't accessible for you at the moment. You can find out more about how to wear a binder safely here.

That's all folks! Thanks again to everyone who sent in their questions, and a huge thank you to Dr Kat for providing such great info! If you are in need of some more LGBTQIA+ support, remember you can reach out here in the forums, or get in touch with the relevant support services here. ❤️🧡💛💚💙💜🖤