Expert discusses unmet needs in urologic care for LGBTQ patients

In this interview, Diana K. Bowen, MD, shares takeaways from the 2022 LUGPA Annual Meeting discussion, “Appreciating Diversity in Urology Care.”Bowen is an assistant professor of Urology at Northwestern University Feinberg School of Medicine.

You were part of the LUGPA discussion “Appreciating Diversity in Urology Care.” Could you share some takeaways from that session?

My talk was really focused on tips and tricks for welcoming any gender-diverse patient into your practice and how to make them have a great health care experience, both in the general clinic sense and for any urologic complaint they come in with outside of the bottom surgery aspect that we talk about so frequently. The takeaways are: don't make assumptions about any patients, ask them about their history, ask them their pronouns, train your staff to address patients in an affirming way—there are many resources for that—and understand that our gender-diverse patients have a history of having many unique barriers to health care, so it's even more important to provide an equitable experience.

Could you talk about some of the biggest unmet needs in urologic care for LGBTQ patients?

Specifically for our transgender and gender-diverse patients, there are still insurance issues and access issues in general. There's also a fear of the health care system; 30% of patients have had a negative health care experience. We are coming into a time where there are lots of positive changes with insurance and access. There's increasing acceptance culturally, and that's going to translate into more patients coming to see us. The more we can take down those barriers to entry—whether they be insurance, or being comfortable with using pronouns, preferred names, and correct terminology—the better.

Could you discuss your own research interests and what you're working on currently?

We have a comprehensive program at Northwestern where we are involved in multiple different research projects, even outside of the urologic space. Specifically, right now, we're embarking on a prostate cancer screening project to better understand in our institution, which is all 11 hospitals in our system, what our rates of prostate cancer screening are in trans women or any non-binary patient assigned male at birth. That'll be important, because there's very little literature on that, so there's no guidelines. I have also just done a survey of the entire pediatric urology network as to how many providers are providing care for transgender patients and what the unmet needs are for adolescents as they emerge into adulthood.