Questions to Ask Your OB/GYN
In between the circa-early 2000s magazines in the waiting room and testing the limits of not looking at your phone as you wait for the doctor, visiting the OB/GYN can be overwhelming. In collaboration with practitioners from my school, Johns Hopkins University School of Nursing and Medicine, we have compiled tips to navigate your next visit to the stirrups.
1. Determine if they are an Obstetrician and a gynecologist
Depending on where you are in your life and your plans to have children, this might be an important distinction. If you are planning on starting a family, select a practitioner who is both to avoid having to switch because yours doesn’t deliver babies It’s a relieving support to continue your care through pregnancy.
If you're not ready to have a baby yet but would like to in the future, ask your OB/GYN about egg freezing or general fertility health. OB/GYNs rarely discuss the subject of fertility until their patient is trying to get pregnant, which can sometimes be too late. If you don't feel fully confident in your fertility knowledge then inquire about it.
This might also be a consideration if you’re trans and aspiring to have children or be a parent. Because of this, all reproductive options and future plans, like sperm banking, should be discussed with individuals prior to obtaining trans-specific medical care and surgical procedures that may reduce their future reproductive options. Additionally, it’s important for trans women and their families to find a provider or center that understands their specific needs and offers services in a caring and compassionate environment.
2. Who are your patients?
Patient diversity and cultural competency is still an issue in medicine, a field still dominated by white men. Do a quick search of the doctor’s background lest your practitioner is discriminatory of your sexuality, gender, or the birth control option you might desire.
According to Hopkins Medicine, there’s no easy way to gauge a doctor’s familiarity with LGBTQ+ care. Organizations like GLMA: Health Professionals Advancing LGBT Equality have created databases to help patients find knowledgeable providers, but options are limited in certain areas. Most patients will need to do their own homework—as suggested above—to find a supportive clinician.
To make sure that the doctor you’ve found is a good fit, have an open conversation during your first appointment. Although you may be fearful of discrimination, open and honest communication is vital to quality medical care.
When meeting with a new physician, start with a question as simple as, “What experience do you have caring for LGBTQ+ patients?” If your provider is not familiar with this area, ask if he or she has colleagues who are. If you encounter hostility, you will need to look elsewhere. Remember, your doctor should be a source of support — not judgment.
And remember, you should feel comfortable talking with your practitioner about everything from discharge to possible left-of-center sexual practises. If you feel uncomfortable in their presence, it’s probably time to look for another practitioner if possible (although we recognize that the pool isn’t wide for every person and environment).
3. Testing: Pap Smear, HPV, & Beyond
Depending on your age and sexual activity, the answer to this will vary. Typically, it’s not necessary until 21-years-old and co-testing (a Pap smear with HPV testing) is usually not necessary until 30-years-old. This is because, according to the American Cancer Society, most young, healthy individuals from age 21- to 29-years-old can rid themselves of HPV.
According to Hopkins Medicine, Trans men are less likely to receive regular gynecological health care services than non-trans or cis-gender womxn — this includes pelvic exams and Pap tests used to diagnose cancers and other conditions early, when they have the highest treatment success rate. Because of this, gynecological conditions and cancers may go undiagnosed till it is too late to provide lifesaving treatment.
Additionally, for trans men taking testosterone, it is still unknown whether long-term use of the hormone impacts the risk of developing gynecological conditions, including cervical or ovarian cancer. Individuals should discuss possible health implications or complications with their provider before hormone use, and receive regular checkups during their use of prescribed hormones. The UCSF Center of Excellence for Transgender Health provides additional information and guidelines for hormone administration.
4. What About Birth Control?
It’s critical to know the corruption of the pharmaceutical industry in medical practises. Although we have come a long way, there are still drugs being pushed onto practitioners by companies and then to patients. So, instead of asking what birth control pill the practitioner would recommend, if that is what you are seeking to use, ask instead: "Here is what is important to me as a person seeking birth control, can you recommend something that fits that description?" This way, you’re clear on what is important to you and your body.
Birth control options, of course, don’t just include the pill, so it’s important to discuss it overall even if you’ve been on the pill or using condoms. What was good for you at 18-years-old might not be the same at 30 or 40 or 50. Even more, since birth control technology and regulations are ever-evolving, check with your practitioner regularly on the state of your method, pill if using, and any personal or industrial changes. This might include being up-to-date on any recalls or warnings with your practitioner as well as hormonal lab tests if necessary.
It’s also your responsibility to keep track of your symptoms if you’re on the pill and let your practitioner know, whether it’s relating to your mental health, weight, or cycle length. Also, if you’re approaching menopause, How about when to come off the pill as you approach menopause?
Don’t wait until your annual exam to check your breasts! Do so monthly as a quick check-in before your shower. You can use this guide.
This also includes Trans men and FTM individuals who do not take hormones and have not undergone “top” surgery — bilateral mastectomy, or surgical removal of both breasts — as the same risks of developing breast cancer remain as nontrans or cis-gender women advises Hopkins Medicine. Therefore, it is important for these individuals to have regular clinical breast exams and screenings, like mammograms, which are used to diagnose breast cancer in its early stages, when treatment is the most successful.
Removal of the breasts reduces but does not completely eliminate an individual’s risk of developing breast cancer. Therefore, trans men who have had a bilateral mastectomy should still discuss their risk of developing breast cancer and available screening options with their provider.