Henry Ng, MD, MPH, is the president of GLMA: Health Professionals Advancing LGBT Equality (formerly the Gay and Lesbian Medical Association) and clinical director of the Pride Clinic, Ohio’s only medical home for lesbian, gay, bisexual and transgender (LGBT) patients.
1. How long have you been president of GLMA? When does your term end?
Since September 2013. Until the end of the GLMA Conference in September 2015.
2. What is your specialty and where do you practice?
I practice in Cleveland, Ohio. Internal medicine—pediatrics (combined training).
3. Do you and other members of the healthcare team treat many members of the LGBT community in your practice?
Yes. I am the clinical director for an LGBT health service line called the Pride Clinic. We were founded in 2007 and were the first hospital-based dedicated LGBT health service in the state of Ohio.
4. Do you and other members of the healthcare team see many transgender patients in the Pride Clinic? Have you seen an increase in those patients?
We see many transgender patients, and have seen a great increase in the number of those patients over the last several years. We started in 2007 with just four patients and now see over 1,000 unique patients in over 2,000 visits a year.
5. Are there health concerns that characterize the majority of your LGBT patient visits?
I work with many students and residents in clinic, and I often say that we practice “primary care plus,” meaning that LGBT patients need all the routine preventive services that all people need and deserve, and also have some unique health concerns related to their positive/negative experiences of being a sexual minority. Some of these concerns include mental health issues (depression, anxiety, substance abuse and PTS from hate-motivated violence, sexual abuse or trauma), coming out to friends and family, family acceptance/rejection, tobacco abuse, sexual health and HIV/STI exposures, among many concerns.
6. Are there health concerns that characterize the majority of your transgender patient visits?
Mental health concerns, such as depression, anxiety, PTS and coping skills with non-supportive environments/families, are unfortunately all too common among our patients.
7. Are there specific issues/approaches that PAs and other providers should think about when treating transgender patients versus others in the LGBT community and the wider communities?
The GLMA “Top 10″ lists are a great place to start for health professionals to familiarize themselves with important health concerns facing the LGBT community. These lists review medical, psychosocial and other important issues that LGBT people experience. Topics like HIV, cancer, tobacco abuse, substance abuse, depression, obesity—all are important health concerns for LGBT populations. Other health concerns, such as aging, heart disease, hormonal care management as we age are also emerging health topics.
8. Does GLMA offer any programs for transgender providers and/or patients?
In addition to our “Top 10″ lists, GLMA provides webinars addressing LGBT health, as well as a provider directory where patients and other health professionals can search for affirming providers in a particular geographic area or a particular specialty. Of course, GLMA’s Annual Conference is another venue where those who wish to learn more about LGBT health can sharpen their skills and also hear about important social, policy and health advances.
9. Have there been educational and/or other experiences that have positively influenced your relationship with transgender patients?
Transgender advocacy has been a central part of establishing rapport with our transgender community in Ohio. I attended local community group meetings before starting the clinic to better understand and hear the community’s concerns and needs. At first, I was received with skepticism and some distrust, but over time, my continued presence at these meetings won over the trust of several transgender leaders, some of whom became patients. Their trust and experience in my care were spread by word of mouth, and many other patients followed suit.
This career path really was a surprise for me. I had not planned to have a career focusing in LGBT health. As part of my residency training, I had to give a talk on an academic topic by the end of my residency. I had realized that no one in our community had addressed LGBT health as a topic ever at my hospital, and over 10 years in the Ohio area. I decided that I would give at least one talk, and regardless of how it was received, I would be satisfied that I had followed my conscience and spoken on behalf of an often invisible part of society. I was amazed that both my presentation and the topic were so well-received, and I was asked to give some version of that talk over and over again. That was in 2005, and that one lecture set all these events in motion.
I became a physician to treat those who are suffering, to teach those who wish to learn the healing arts and to end health disparities of vulnerable populations. I discovered that my personal mission is to create change within systems, whether the change influences patient care, medical education or health policy. I believe that each of us has within us the power to advocate for change and that these issues all intersect. The #blacklivesmatter, #sayhername, #transhealthfails and many other movements are all part of our goal for health equality.
Henry Ng, MD, MPH, is an internist-pediatrician at MetroHealth Medical Center in Cleveland, Ohio, and an assistant professor at Case Western Reserve University School of Medicine.