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OHSU expanding, improving transgender health services

New staff, projects seek to better meet the needs of transgender patients
doctor in scrubs performing surgery
Daniel Dugi, M.D., FACS, co-founder of the Oregon Health & Science University's Transgender Health Program and its surgical medical director. Dugi is one of a handful of reconstructive urologists who primarily focus on gender-affirming genital procedures, such as vaginoplasties, for vaginal construction. (OHSU/Fritz Liedtke)

Transgender and non-binary Oregonians will soon have expanded access to care and services with the continued growth of the Oregon Health & Science University Transgender Health Program.

OHSU is adding four new staff members, creating its first-ever fellowships in gender-affirming surgical care and is involved in a number of projects to further advance its Transgender Health Program, which launched in 2015 to ensure patients receive respectful and quality health care regardless of their gender identity.

Caring for more than 1,000 adult and youth transgender patients, OHSU has one of the largest and most comprehensive transgender health programs in the U.S.

“OHSU is committed to providing compassionate and competent health care to every Oregonian, including transgender individuals,” said Renee Edwards, M.D., M.B.A., vice president and chief medical officer of OHSU Healthcare. “The addition of new staff and projects to the OHSU Transgender Health Program demonstrates our long-term commitment to ensure OHSU has the resources needed to meet the real and pressing health needs of the transgender community.”

Geolani W. Dy, M.D.
Geolani W. Dy, M.D.
Jyoti Chouhan D.O., Pharm.D.
Jyoti Chouhan, D.O., Pharm.D.

Two new urology surgeons – Jyoti Chouhan, D.O., Pharm.D., and Geolani W. Dy, M.D. – will soon offer more options for individuals seeking gender-affirming genital surgeries. And two new psychologists – Danielle Moyer, Ph.D., and Mary Marsiglio, Ph.D. – will soon provide mental health care to pediatric and adult transgender patients, respectively. The above providers will arrive at OHSU between August and November 2019.

Mary Marsiglio, Ph.D.
Mary Marsiglio, Ph.D.
Danielle Moyer, Ph.D.
Danielle Moyer, Ph.D.

The four new hires will join an already robust transgender health team at OHSU, including:

  • Jens Berli, M.D., is one of just a few surgeons in the U.S. who is specially trained to perform phalloplasties with a urethra, which allows transgender male patients to urinate through their penis.
  • Daniel Dugi, M.D., FACS, is a program co-founder and its surgical medical director. Dugi is one of a handful of reconstructive urologists who primarily focus on gender-affirming genital procedures, such as vaginoplasties, which construct vaginas.
  • Christina Milano, M.D., is a program co-founder and its medical director. Milano is a family medicine physician and provides holistic primary and transition-related care to gender-diverse individuals.
  • Kara Connelly, M.D., is a pediatric endocrinologist and medical director of the OHSU Doernbecher Children’s Hospital Gender Clinic, which provides hormone therapy and other services to transgender youth.
  • Lishiana Shaffer, M.D., is an obstetrician and gynecologist who provides transition-related gynecologic surgery and gender-affirming obstetric care for transgender and gender-diverse individuals through a dedicated weekly transgender health clinic.
  •  Amy Penkin, M.S.W., LCSW, is the program’s supervisor and Jess Guerriero, M.S.W., M.A., is the program’s intake and referral specialist. Both social workers, they often serve as safe and welcoming first points of contact for new transgender patients. Penkin leads institutional efforts toward greater inclusion and Guerriero supports patients by providing information, education and referrals, accompanying them during exams, and much more.
Christi Butler, M.D.
Christi Butler, M.D.
Blair Peters, M.D.
Blair Peters, M.D.

Starting in summer 2020, OHSU also will employ two fellows specifically focused on transgender surgery: Blair Peters, M.D., and Christi Butler, M.D. They will be mentored by Berli and Dugi in gender-affirming surgeries of the chest, face, penis and vagina.

In direct partnership with the community, the Transgender Health Program also is facilitating a Community Advisory Board comprised entirely of transgender and gender-diverse members. The board, which initially has six members and meets quarterly, will help the program be more transparent and better align with the needs and priorities of the patients it serves.

After years of informally collaborating with other institutions that also offer transgender health care, OHSU has established the Academic Gender Center Coordinators’ Consultation. The group meets monthly via telephone to discuss priorities, challenges, resources and strategies so all organizations can collaborate to better meet transgender community needs.

dr berli on right, talking and smiling with a patient
Surgeon Jens Berli, M.D. (right) meets with a patient, in May, 2018, during a post-surgery follow-up. (OHSU/Kristyna Wentz-Graff)

To improve collaboration between health care providers who work directly with transgender patients and researchers studying transgender health issues, OHSU has established the Transgender Health Program Research Collaborative. OHSU faculty are active in research related to transgender care, including mitigating complications from phalloplasty surgery, examining the medical necessity of facial feminization procedures, and evaluating pelvic floor physical therapy to improve vaginal surgery outcomes. They have published more than 20 papers and given more than 30 podium presentations on research related to transgender health.

A May upgrade of OHSU’s electronic health record system included broader options for recording a patient’s gender identity, sexual orientation and other relevant information, such as chosen names and pronouns. The system previously only allowed records to display the sex of the patient as “male” or “female” based on the sex they were assigned at birth. Today providers can document the patient’s gender identity, and this information will be displayed more prominently on the electronic health record. The change ensures patients are greeted by staff with the names they use, which helps create a more welcoming and supportive environment.

On Saturday, Sept. 21, OHSU will host a continuing medical education course to help the region’s medical and mental health providers better understand and appreciate the unique needs of transgender patients.

OHSU also just wrapped up a three-month-long survey about the health needs and experiences of Oregon transgender youth. Conducted with the support of a $7,000 grant from the Oregon Health Authority, the study will help both OHSU and the OHA to better serve this underrepresented community.



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