My friend was referred to a urologist, is this normal?

[Elsa.G]

I have a friend that had SRS last year and had some follow up appointments with the doctors after as is needed. She made and attended a appointment with a pretty acclaimed gynecologist in my area, shes a 30 something woman who also happens to be my cousin and aunt's ob/gyn. Anyway my friend has been very upset because the doctor cut her appointment short, according to my friend the doctor told her that she was a doctor in the field of women's health and couldnt really do much for her, she told her its not appropriate for her to see a ob/gyn and tried referring her to a urologist. Im wondering is this fair? I understand to an extent but it didnt seem fair to me. My friend who ill call Mary was extremely upset, she felt discriminated in a way she told me b4 the appointment how excited she was to see a gyno because she said she felt more womanly but now shes starting to feel very low. To make matters worse she's spoken to another ob/gyn who also told her that it would be best if she saw a urologist and told her there was no need to see a ob/gyn. Im confused about this......

[Aidan_]

Well seeing as your friend who's had SRS still does not have ovaries, a uterus or other female parts like that, there's not a whole lot more a ob/gyn could do versus a urologist. Urology doesn't purely address males though, many women have to see one. Ob/gyns just deal with the complex parts, while a urologist will do the job your friend probably needs a bit better.

At least that's how I understand it, forgive me if I'm wrong.

[Cruelladeville]

On a sorta technical level would be fair to say Gynaecology deals with medical aspects of health of the female reproductive system (uterus, vagina and ovaries)....

So as we TG women only have neo-clitoris and vaginas that's really just the first part stuff....not mixed with the deep internals...

However we have enough to be of 'interest' to someone who's not bigoted me thinks.... though they might not be familiar with the reconstituted aspects, which is why they might turn you down?

I'd stick to medics that know what you've been through and exactly what to look for.... so that means the Dr that do SRS, for serious complications....

Anything else a general dr/gp should do....

[Cindy Stephens]

When I first went for hormones, one of the options given by my shrink (a long time specialist in trans and sex problems) was to see an ob/gyn who saw some of her patients.  So some do see trans people.  They would be aware of hormonal issues, breast issues etc.  It may be that this one, in particular, did not feel comfortable with trans specific problems.  It does require additional research and study.  It sounds, perhaps, that there may have been a communication breakdown.  Did your friend mention that she was trans and clear it first, while making the appointment? 

[Elsa.G]

When I first went for hormones, one of the options given by my shrink (a long time specialist in trans and sex problems) was to see an ob/gyn who saw some of her patients.  So some do see trans people.  They would be aware of hormonal issues, breast issues etc.  It may be that this one, in particular, did not feel comfortable with trans specific problems.  It does require additional research and study.  It sounds, perhaps, that there may have been a communication breakdown.  Did your friend mention that she was trans and clear it first, while making the appointment?

So far the ob/gyn's that my friend has been to have stated that there is no need to see a gyno for trans issues, and yes they both were aware of the trans part. The doctors have also both stated that trans issues including the neo-vagina are not women's health issues so they dont especifically deal with it, hence they have tried to refer my friend to a urologist instead or recommended her srs surgeon for any issues mary might deal with. The first doctor told mary that she had a very good vaginal appearance but that's about it, she said since its a cosmetic procedure that that theres not more she can do to help. The thing thats upsetting is that mary doesnt wanna let go of it and shes determined to see a gyno.....

[Cindy]

Depending where you are a Urologist is more likely to do the surgery, unless you go to a specialist (Suborn etc), who I think are still technically Urologist with plastic surgery degrees? I'm not sure. A gynecologist is useful to assess how your responses post surgery, and to have a look and think about development. The key player tends to be the endocrinologist who monitors the hormones. And of course  the psychologist who says yea or nay. I think you have more checks post SRS with a gynecologist than pre, and no, not for PAPs.
In this case it sounds like inexperience, which is a worry.

Cindy

[spacial]

Sounds like the gynocologist just doesn't want to do the job. Probably thinks she's a wee bit too important for such matters.

In that case, walk away.

Sooner get attention form someone with some manners and intelegence than some idiot with a chip on their shoulder.

Some of these feminist Drs can be quite vicious as well.

[Cindy Stephens]

Why do I think some part has been left out of the story?  Are you saying that you friend called the ob/gyn office, told them that she was a transsexual and just wanted a check-up for female issues, was told yes that would be fine, and then when she got there was told they don't do "->-bleeped-<-s?"  Or was she looking  for a specialist in the plastic surgery field and assumed that an ob/gyn fit the bill?  I really don't want to over-think this but sometimes we tend to jump to the worst possible conclusions "vicious feminist Drs" when nothing untoward was meant.  It seems to me that a "vicious feminist dr" wouldn't have set up an appointment to begin with.  If it were related specifically to the SRS, then I wouldn't think that an ob/gyn would be the appropriate person.  Breast and hormones, yes.

[regan]

Without knowing the full details, was it related specifically to vaginal/clitoral issues or was it just a general problem "down there".  So its hard to say if the doc's response was anti-trans or if it was more of an outside her speciality (ie, not a OB/GYN issue).  A vagina is a vagina, so not knowing the rest of the story, it sounds more like the doc was actually referring her to the right specialist.

Then again, private practice doctors can pick and choose her patients and regardless of the reason if she's not comfortable with after market vaginas, she has a right to say so.  Truth is, considering the wrecked genitals she's probably seen as part of her practice (dentists and OBs are lot the same in that regard), an aftermarket vagina is probably in better shape then anything else she's seen - so I doubt she's anti-trans.

[Elsa.G]

Why do I think some part has been left out of the story?  Are you saying that you friend called the ob/gyn office, told them that she was a transsexual and just wanted a check-up for female issues, was told yes that would be fine, and then when she got there was told they don't do "->-bleeped-<-s?"  Or was she looking  for a specialist in the plastic surgery field and assumed that an ob/gyn fit the bill?  I really don't want to over-think this but sometimes we tend to jump to the worst possible conclusions "vicious feminist Drs" when nothing untoward was meant.  It seems to me that a "vicious feminist dr" wouldn't have set up an appointment to begin with.  If it were related specifically to the SRS, then I wouldn't think that an ob/gyn would be the appropriate person.  Breast and hormones, yes.

Well im just describing the story based on what mary told me, i have a feeling the doctor maybe wasnt willing to help based the fact that mary is trans. I dnt understand why this couldnt have been told to mary since the beginning? My cousin has been going to this ob/gyn for 3 yrs since she was 18 and she told me that she is friends with one of cousins aunts who is a pretty conservative woman. I dnt know what other details there might be

[Elsa.G]

Without knowing the full details, was it related specifically to vaginal/clitoral issues or was it just a general problem "down there".  So its hard to say if the doc's response was anti-trans or if it was more of an outside her speciality (ie, not a OB/GYN issue).  A vagina is a vagina, so not knowing the rest of the story, it sounds more like the doc was actually referring her to the right specialist.

Then again, private practice doctors can pick and choose her patients and regardless of the reason if she's not comfortable with after market vaginas, she has a right to say so.  Truth is, considering the wrecked genitals she's probably seen as part of her practice (dentists and OBs are lot the same in that regard), an aftermarket vagina is probably in better shape then anything else she's seen - so I doubt she's anti-trans.

The first doctor is private and the other works with a colleague, both gyno's stated that trans vaginal issues are not womens issues therefore they couldnt help her. Mary cant comprehend it....

[Sandy]

It may have been a bit abrupt, but, that really is probably most appropriate.

An ob/gyn has their training for all the internal organs that gg's are born with, uterus, ovaries, fallopian tubes, cervix, as well as the vagina.  And those delicate organs can have a lot of complications.

For we trans women, most of our issues are primarily external and urological.  The one serious condition that can affect both gg's and trans women are vaginal fistulas.  And while an ob/gyn could diagnose this condition, they would probably consult with a urologist.

Vaginal infections can also be diagnosed and treated by a urologist.

Also, if a gg has a urological issue they would probably be referred to a urologist.

I had this discussion with my physician as I was going through my transition, who has several trans patients and he was quite informative about the topic.

I do see a urologist who did my orchiectomy and also did a follow up with me after I had my SRS.

-Sandy

[regan]

The first doctor is private and the other works with a colleague, both gyno's stated that trans vaginal issues are not womens issues therefore they couldnt help her. Mary cant comprehend it....

Private practice refers to non-emergency room doctors and the like who have an obligation to treat anyone who walks through their door.  As for "trans vaginal", I'm still not sure we're getting the whole story.  For example, if her urethrea were displaced as part of the GRS, affected by scar tissue, etc that is indeed a urological issue.  Of course, they still have the right to refuse to treat anyone, for any reason, so that may be exactly the case.

[KillBelle]

i had to go to a urologist but that was because i had a uti..   =[[[

[Northern Jane]

I would suspect that the gynaecologist's position may have been more related to the care your friend needs and the gynaecologist's work load.

I was recently referred to a gynaecologist by my GP and the wait time was 6 months for "non-critical care". I got in in 3 months by going on standby and the doctor was very kind and helpful in dealing with some issues that were typical of post-menopausal women and were specifically of a gynaecological nature. Considering the lengthy waiting list, I could understand a gynaecologist not wanting to deal with things outside of their speciality.

(Strangely enough it was a gynaecologist who became my champion in the 1960's and arranged my HRT, psyche evaluation, and played a critical role in helping me find a surgeon for SRS. He also looked after my care until I was fully healed.)

The doctor mentioned seemed a bit abrupt but obviously didn't feel qualified to treat your friend. Re-constructive surgery for genetic females is usually handled by a urologist.

[spacial]

The more I think about this the more I agree with Northern Jane.

I was being a bit too blunt in my last post. I do have a tendency to judge harshly when it comes to medical types.

Apologies.

[JennX]

Well seeing as your friend who's had SRS still does not have ovaries, a uterus or other female parts like that, there's not a whole lot more a ob/gyn could do versus a urologist. Urology doesn't purely address males though, many women have to see one. Ob/gyns just deal with the complex parts, while a urologist will do the job your friend probably needs a bit better.

At least that's how I understand it, forgive me if I'm wrong.

This is correct.

Many well known SRS surgeons are Urologists. This is their specialty. They just also happen to specialize in reconstructive surgery as well. Unless something else was said, or was inflected in the way the suggestion was delivered, a urologist or urology surgeon (from a purely medical standpoint) would be more well equipped to help your friend than any OB/GYN. It has more to do with anatomy and physiology than anything else.