Hospitals

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Hospitals

==== The Triangle Program at Arbour-HRI Hospital ==== (Link Checked 9.13)

in Brookline, MA First partial hospitalization program in the Boston area that comprehensively responds to the complex mental health needs of gay, lesbian, bisexual and transgender people. The Triangle Program provides treatment for these individuals who are dealing with co-occurring mental health issues, including trauma and/or substance disorders.(Link Checked 7.12)

==== Beth Israel Deaconess Medical Center ==== Hospital staff is provided with a cultural competency training addressing healthcare issues relevant to the transgender community, according to HRC. The Patients Bill of Rights includes “gender identity and expression” (Link Checked 7.12)

Boston Medical Center

The BMC has an endocrinology department which is fairly expert in trans issues. Dr. Joshua Safer was, at last contact, their go-to endo for trans folk. Several other BMC endocrinologists also provide transgender treatment services. (Link Checked 7.11)

UMass Boston Medical Center / Worcester

Baystate Medical Center

Bayste Health Center and its affiliated branches (Brightwood Health Center, Franklin Medical Center, Highstreet Health Center, Mary Lane Hospital, Mason Square Neighborhood Health Center, Baystate Regional Cancer Program, and Baystate Visiting Nurse Association & Hospice) Baystate is located in Springfield, MA. Hospital staff is provided with a cultural competency training addressing healthcare issues relevant to the transgender community.

Dana-Farber Cancer Institute Hospital staff is provided with a cultural competency training addressing healthcare issues relevant to the transgender community. The Patients Bill of Rights includes “gender identity and expression”, according to HRC (Link Checked 7.12)

==== Lemuel Shattuck Hospital ==== (Link Checked 7/12)

Veterans Hospital - Jamaica Plain, MA

Veterans who would like to access the VA and would like a trans-friendly contact at the Jamaica Plain Hospital can contact Jillian Shipherd, PhD at 617-232-9500 ext 45821. Lemuel Shattuck Hospital

Brigham and Women's Hospital Hospital staff is provided with a cultural competency training addressing healthcare issues relevant to the transgender community. The Patients Bill of Rights includes “gender identity and expression”, according to [1] Lemuel Shattuck Hospital

Children's Hospital

Children's Hospital serves people through the age of 18.

New clinic addresses intersex and gender issues

On February 23 (2007), a new multidisciplinary clinic at Children's Hospital Boston's saw its first patients with what are called disorders of sexual differentiation (DSD). The program primarily serves infants, children, adolescents and young adults with genitourinary or hormonal disorders or other medical issues that may make it difficult to determine their sex, and that may interfere with sexual and reproductive function. Girls with congenital adrenal hyperplasia (CAH), for example, are overexposed to masculinizing hormones in utero and may be born with the genital appearance of boys.

While Children's has long treated the physical manifestations of DSDs, the new clinic is also designed to address psychosocial issues that may arise from genital and gonadal variability. In addition to urologists, endocrinologists and geneticists, the team includes social workers, nurses who have run support groups and a research psychologist.

In the past, DSDs were regarded as medical emergencies that needed to be addressed immediately. Parents were not always involved in the decision-making process, which varied from center to center. In recent years, however, adult patients have formed national advocacy groups that have changed the thinking about how to manage DSDs, and today, families are intimately involved in the decisions.

"It's more important to make the best decision than to make the fast one," says Norman Spack, MD, of the Endocrinology division at Children's, who co-directs the new clinic with David Diamond, MD, of Urology. "In some cases, it can take weeks to decide what's best for the patient," he says. "It's a team decision now, and no matter what's done, the parents need support and the children need to be followed." Follow-up research will be conducted to determine the efficacy of the approaches taken and patient satisfaction as they enter adult life.

As more prenatal ultrasounds and chromosome analyses are performed because of advanced maternal age, DSDs are being anticipated even in the womb. "The chromosomes and genital appearance may be discordant," says Dr. Diamond. "It may not be exactly clear what is going on until the child is born, and this can produce great family anxiety." In such instances, the program serves an important teaching function.

Unique in the Western hemisphere, the clinic will also care for children and young adults who present as transgendered—those who have no known anatomic or biochemical disorder, yet feel like a member of the opposite sex. Such feelings can emerge early, even in the preschool years, and can cause considerable psychological distress. For that reason, transgendered young people are often assumed to have a psychiatric disorder and are placed on psychotropic medications. By late adolescence, a high percentage have attempted suicide.

"This will be the first major program in the country that is not only treating DSDs, but also welcoming young people who appear to be transgendered and are considering medical protocols that might help them," says Dr. Spack.

Children's Hospital Boston
300 Longwood Avenue | Boston, MA 02115 | 617-355-6000 www.childrenshospital.org (Link Checked 6.11)

Policies

From the Code of Ethics for Emergency Physicians:

II. B. 3. Fairness (Approved 1997; Revised October 2005)

Emergency physicians should act fairly toward all persons who rely on the ED for unscheduled episodic care. They should respect and seek to understand people from many cultures and from diverse socioeconomic groups. In the United States emergency physicians provide necessary emergency care to all patients, regardless of ability to pay. Emergency physicians also should strive to avoid having patient finances govern access to appropriate inpatient or follow-up medical care. Provision of emergency medical treatment should not be based on gender, age, race, socioeconomic status, sexual orientation, real or perceived gender identity, or cultural background. No patient should ever be abused, demeaned, or given substandard care. (Link Checked 7.12)