UMHS grad Søren Estvold, MD, MPH hosts “LGBTQ+ Medicine & Theory: Providing Compassionate Care” on Wednesday, June 22, 2022 at 7pm Eastern. Dr. Søren Estvold, MD, MPH (Class of 2018) is in a Family Medicine residency at Augusta University Medical Center in Georgia. This is the second year in a row Dr. Estvold has hosted a livestream event on LGBTQ+ Medicine for UMHS.
UMHS spoke to Dr. Estvold about his work treating LGBTQ+ patients during his residency and also volunteering at an LGBTQ+ clinic in Augusta, GA and more.
Family Medicine residency in Georgia
Dr. Estvold spoke about his work in Family Medicine.
“I'm a rising PGY three at Medical College of Georgia,” he said. “You guys may know that from Augusta, Georgia, where a lot of us rotate through. I'm one of their Family Medicine residents. I graduated in 2018, but I didn't start residency right away. I actually worked in maternal fetal medicine for two years and did lots of volunteer work until I finally matched here at MCG. And then I've been living the Family Medicine life for the last two and a half years.
Equality Clinic in Augusta, GA
Dr. Estvold started out volunteering at the Equality Clinic in Augusta before finally matching at Augusta University Medical Center.
“It's a student-led clinic that where we treat the LGBTQ+ community here in Augusta, Georgia. And we primarily do hormone replacement therapy for the transgender community. So that has been going on for about three years with me. I've been volunteering there. I actually am one of the physicians there that sees patients and helps them with their transition and helps start them on hormones or continues them on hormones.”
Paths to becoming an LGBTQ+ Medicine specialist
Primary care doctors can learn to treat LGBTQ+ patients as part of a regular Family Medicine practice.
“As a primary care physician, of course I treat everybody. I primarily focus about half my patient population on the LGBTQ community, especially the transgender community. Now, how you do that is you do a lot of self-teaching. I had a great mentor at my program who taught me how to do transgender medicine, including hormone replacement therapy. But as a family medicine doc, it sets me up perfectly to follow these patients over an extended period of time. As we all know, a transition takes many years. So as a Family Medicine doctor, it really helps me to see them consistently through their transition. Now you don't have to just do family medicine. You can be an Internal Medicine doctor, which is very similar. You could probably get into it if you wanted to be an ER doc, but that's more acute care. But anyone who is more of a primary care physician who will be able to see these patients over a series of years. And that will help get you set up to do a fellowship in LGBTQ+ medicine, not just transgender medicine. And there's actually a couple of those fellowships throughout the US. Mostly they're the larger urban cities like California, New York, Chicago, I believe.”
Transgender medicine fellowships
LGBTQ+ Medicine doctors who specialize in Family Medicine or Internal Medicine are different from surgeons who perform sexual-reassignment surgeries. These are often OB-GYN or Urology specialists who have completed a fellowship in Transgender Medicine.
“An OB/GYN would do a lot of the surgeries, a urologist would do a lot of the surgeries. As a primary care specialist, we're not surgeons; we're not trained in surgery, although we can do minor surgeries. So we, as primary care doctors, will be more focused on keeping patients healthy, helping to transition them with their hormones, but then doing all of their primary care workup, like making sure they don't have diabetes, high blood pressure, stuff like that.”
How Primary Care doctors can treat LGBTQ+ patients
Whether one is an Internal Medicine doctor or a Family Medicine doctor, you can still be treating LGBTQ+ patients without having to do a fellowship. It's just some extra things that you need to learn.
“LGBTQ+ people need a primary care physician as well. So just to be really good at it, you just have to do kind of your own learning and really just work with this patient population and get to know them.”
What are key things future and current doctors should know about treating LGBTQ patients, especially now that some states are passing laws that some say hinders the human rights of this community?
“The LGBTQ+ population is very marginalized and they're very reluctant to seek healthcare because they're afraid of the stigma associated with it and being stigmatized as a patient. Unfortunately, it happens in every healthcare setting. One thing that you can do is remember that these patients are just as nervous to meet you as you are to meet them. So, proceed with as much empathy as you can. Take your time with these patients and really get to know them. And then really treat them like any other patient. Screen them like you would any other patient. Make sure that you're meeting their healthcare needs as a primary care physician."
Opportunities for future doctors
Current and prospective students should learn how to properly care for the LGBTQ+ community because a percentage of patients identify as LGBTQ+. There are also great job prospects for those with experience treating LGBTQ+ patients.
“LGBTQ+ medicine is a very new and burgeoning field. It's very exciting and there's a lot of opportunities within it. I think if you want to become a primary care physician, there's lots of space for you to grow within this field. And remember, you're going to encounter an LGBTQ person in your practice probably at least every week, if not once a day. So really this is something you should sharpen your skills on and learn how you can best provide care for this population.”
Scott is Director of Digital Content & Alumni Communications Liaison at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.