The AAO Journal, 2023/06, 33(2):12. doi: 10.53702/2375-5717-33.2.10, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

case report [736]
healthcare needs [1]
male [861]
models [67]
OMT [3925]
osteopathic manipulative treatment [3946]
therapeutic process [61]
transgender [8]

Abstract:

Introduction/Background: Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual and Plus (LGBTQIA+) individuals face significant health disparities and are underrepresented within the healthcare system. These individuals often do not receive care due to perceived stigma, healthcare knowledge deficits, and discrimination. These individuals have unique needs and this can contribute to health disparities. Case: The patient is a 24-year-old Caucasian, transgendered, male who began testosterone therapy for gender dysphoria in 2016. He is status post (s/p) bilateral mastectomy in 2019. He initially presented to our clinic in 2020 for 4 years of back pain and poor posture. Osteopathic Manipulative Treatment (OMT) and intermittent Physical Therapy was instituted. Results: This patient has continued to find improvement with OMT and has inspired thought on how transgender patient care can be seen through the 5 Models of Osteopathic Medicine including, but not limited to: • Biomechanical: postoperative fascial changes, poor posture • Respiratory-Circulatory: risk of postoperative lymphedema, cardiac arrhythmias, or lung disease • Neurological: chronic pain facilitation and autonomic dysregulation • Metabolic: physiologic changes due to hormone therapy • Behavioral: psychologic changes with gender dysphoria and increased risk of depression/suicide Discussion: Special considerations must be taken for LGBTQIA+ individuals. Addressing all aspects of health allows for improved outcomes and enables patients to obtain appropriate health care in areas needed most. In the literature, OMT has proven to be a safe, effective treatment in common complaints not specific to LGBTQIA+ patients and can provide a holistic approach to care. This case study is limited to a transgendered male approach of understanding LGBTQIA+ healthcare needs. Further studies could include a 5 Models approach to patient intake or evaluating specific somatic dysfunctions per transgender population.