In September 2023, the Sexology Department at Brno University Hospital (FN Brno) opened a specialised gynecological outpatient clinic to provide care for transgender patients. In almost two years, the clinic has so far provided care for 80 clients.
Transgender men – who were assigned female at birth and have undergone or are undergoing gender reassignment therapy to male – also need gynecological care, but often feel uncomfortable and out-of-place in standard gynecological clinics. It was in an effort to accommodate these patients that the management of the Sexology Department chose to establish a specialised clinic, the only such facility in the Czech Republic.
The majority of clients at the clinic are trans men; only two clients are trans women. 40% of clients are from Brno. Their average age is 22.4 years, and the average age before starting testosterone therapy is 20.5 years.
The outpatient clinic specialised for transgender people brings a number of advantages. The staff have sufficient time for examinations and are trained to work with clients with gender dysphoria. In other gynecological outpatient clinics, for example, there are difficulties reporting the gynecological prevention code for male birth numbers. The outpatient clinic is also decorated in neutral colors to ensure that clients feel comfortable.
Gynecological care for trans men has numerous specific characteristics, including consultations on the use of hormonal treatment, recommendations for thrombophilia testing, consultations about the possibility of definitive procedures (in particular removal of the ovaries, fallopian tubes and uterus), and detailed education about the effect of testosterone on the biologically female body. Gynecological care includes consultation about general and gynecological medical history, familiarization with the procedure of a gynecological examination, and answering questions, while the gynecological examination itself includes the collection of oncological cytology, pelvic ultrasound procedures, education regarding the effect of testosterone substitution on the patient’s sexual life, and recommendations for HPV vaccination.
The main reasons for visiting the clinic are for a check-up before starting testosterone therapy, an examination before a commission of the Czech Ministry of Health, solving a specific gynecological problem, or a routine check-up. The patients most often suffer from vaginal discharge, vaginal dryness, and dyspareunia.
Although the majority of clients are trans men, trans women also require this type of care. In this case, the care may involve a check-up after a recent vaginoplasty, consultation on specific client problems, a PSA check-up, or an ultrasound examination.
The outpatient clinic for transgender people has received very positive feedback from patients; thanks to this concept of care, they are not worried about further check-ups, and also recommend the clinic to each other.
