Lancaster Physician Winter 2021 - 7

WINTER 2021

T

he atmosphere at Penn State
Health's Gender Health Clinic
is more informal than many
doctor offices.

Whether in person or during a virtual
visit, patients see no white doctor coats
and quickly learn no personal conversation
is off the table.
" We want people to know they can be
themselves, " said Amy Keisling, clinic
coordinator. " In some cases, this is the
first place they have ever been able to be
themselves. "
Penn State Health has provided gender-affirming care to youth for many years.
But last fall the Gender Health Clinic, part
of Penn State Children's Hospital, opened
with the idea of creating a comprehensive
program with a variety of specialists trained
in gender care for children, adolescents,
and young adults up to age 24.
The clinic team also includes Dr. Claire
Roden, adolescent medicine specialist and
assistant professor of pediatrics at Penn
State College of Medicine, Dr. Katharine
Dalke, psychiatrist and assistant professor
of psychiatry and behavioral health, and
Drs. Kanthi Krishna and Daniel Hale, both
of whom are pediatric endocrinologists.
The end goal for the clinic is for young
patients who have challenges related to
their gender, sexuality, or sexual development to feel comfortable in their bodies
and affirm their gender.
" I tell patients I want them to have the
life they want, " Roden said. " A lot of times,
I am one of the first doctors they see who
isn't trying 'to fix' them. "
Staff offer psychosocial and physical
evaluations, along with ongoing care that

includes gender-affirming counseling and
medical care. The clinic provides fully
reversible treatments, such as menstrual
suppression and estrogen or testosterone
blockers, as well as more permanent hormonal therapies.
The clinic does not provide gender-affirming surgery but does make referrals
for patients.

Dalke said she wants to reach out to
more parents, pediatricians, and young
adults who may not know where to turn for
information about gender health services.
In the short time since the clinic opened,
it is evident it is providing an important
service as the number of patients steadily
grows. Thanks to telehealth, the staff can
see patients who live farther away from
the Hershey-based clinic.

One of the important messages to
patients and families, said Roden, is that
there is no rush on making big decisions.

" We know we are filling a need, " said
Dalke. " It's clear a lot of young people
weren't getting the care they needed. "

" We try to be a really normalizing and
affirming place, " she said. " I tell patients
'I am not in a rush. You don't have to be
either. You can tell me when you're ready
to make a decision about what you want.' "

Part of that care is helping a patient's
community affirm their gender. Dalke
spends time talking to school districts,
explaining why it is important to honor a
young person's chosen name and pronouns.
Discussions with school leaders address
issues that can make her patients anxious
such as what bathroom or locker room
they can use. She also steps in and holds
conversations if a patient is being bullied.

Moving forward with irreversible gender-affirming care only happens when a
patient is insistent, persistent and consistent in who they are and what they
want to do.
The need for the clinic is increasing
as the number of transgender youth
seeking clinical care grows. About 1.4
million people in the U.S. identify as
transgender, according to research from
the Williams Institute at UCLA School of
Law, a research institute whose numbers
are widely accepted.
One reason the population is increasing
is because younger adults are more likely
than older ones to say they are transgender,
said Keisling.
Generally, this group of young adults
is underserved and misunderstood. They
hesitate to seek medical care because of
fears of how they will be treated. The clinic
is working to change that perception.

Spreading awareness of the services provided by the clinic is part of the mission.
Along with talking to families and schools,
clinic staff educate health care professionals
who may feel intimidated when caring for
a transgender patient.
Dalke believes the role of the clinic will
grow. Eventually, its staff plans to create
support groups and work with other
programs at Penn State Health and the
College of Medicine to make certain they
are transgender-accepting and affirming.
They want to strive to better engage the
community and be a leader in research.
" We now can see the needs, " said Dalke.
" Our goal is to meet them. "

For more information about the Gender Health Clinic,
call 717-531-7235

LANCASTER

7

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Lancaster Physician Winter 2021

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