A guide to gender-affirming care at USC

One-third of the respondents to a 2015 National Center for Transgender Inequality survey who saw a provider within the last year shared at least one bad experience with a doctor or healthcare provider related to being transgender. (Christina Chkarboul | Daily Trojan)

USC’s medical facilities — Keck Medical Center of USC and its various hospitals and USC Student Health, a branch of Keck Medicine of USC— received the distinction of “LGBTQ+ Healthcare Equality Leader” in March, marking the sixth time Keck Medicine Hospitals have received the distinction. This year, Student Health participated in the survey for the first time.

The title was only given to healthcare facilities that received a perfect score in the Human Rights Campaign Foundation’s 2022 Healthcare Equality Index. HRCF created the index in 2007 to create a national standard for LGBTQ+ patient care and examine the current state of healthcare facilities. 

Keck Medicine and Student Health performed flawlessly in four distinct criteria: non-discrimination & staff training, patient services & support, employee benefits & policies and patient & community engagement.

The commitment to open dialogue with the LGBTQ+ community and the ways in which Keck Medicine engages with the voices of students were key to the high rating, said Dr. Patty Pinanong, the lead physician of the Student Health gender-affirming care team.

Student Health created the gender-affirming care center in 2013, after Pinanong’s team was approached by students who expressed a need for affirming services at the University. Pinanong cited a 2015 survey by the National Center for Transgender Equality, which found that one-third of respondents who had seen a provider in the past year reported at least one negative experience with a doctor or other healthcare provider related to being transgender. This lack of affirming treatment widely reported by transgender individuals is one of the reasons why Student Health’s multidisciplinary team is determined to meet the needs of its patients. 

“We have people from our mental health team, Relationship and Sexual Violence Prevention and we also have members from our psychiatry team, so that’s the mental health component,” Pinanong said. “Then on the medical side, we want to make sure that we’re providing really affirming primary care.”

Student Health exclusively serves students, while Keck Medicine and its various hospitals serve patients from the greater Los Angeles area. Keck Medicine and its various hospitals had no gender-affirming care program until 2020, when the coronavirus pandemic provided an opportunity to redefine what it meant to have such a program. 

“When the pandemic happened, a lot of our inpatient services were curtailed. I had more time and this was the time to really start developing, ‘What [did we want our] gender affirming care program to look like?’” said Lindsey Morrison, process architect with Keck Medicine’s Office of Performance and Transformation and co-chair of Keck Pride, the LGBTQ+ employee resource group.

During these talks about the creation of a gender-affirming care program, Dr. Laura Taylor also was onboarded. Morrison said Taylor’s hire was the silver lining of the pandemic, as it gave an opportunity to build a strong gender-affirming care program with passionate and recently onboarded physicians.

Taylor now serves as the medical director of Keck’s Gender-Affirming Care Program. She provides primary care and hormone management for transgender, nonbinary and gender-nonconforming individuals, and is experienced in affirming preventive and gynecologic screenings, mental health, sexual health and HIV prevention, among other things. 

Alongside Taylor are other physicians and healthcare experts that work together to create a robust program offering services that include hormone therapy, voice therapy, STI testing and treatment, physical therapy, mental health care, gynecologic care, gender-affirming surgical and primary care and chronic disease management. 

“[We worked] with Dr. Pinanong and really [modeled] what Student Health had already done to make sure that we were creating a warm handoff between Student Health and the Hospitals when students needed to come over for surgical care or higher level care that Student Health can’t provide,” Morrison said.

Keck Medicine and its hospitals serve patients from all over the greater Los Angeles area, whereas USC Student Health solely serves university students. (Christina Chkarboul | Daily Trojan)

Keck Medicine prides itself on its dedication to collaboration and the steps it has taken to ensure the high quality of gender affirming care, Taylor said.

“The thing that I think we’ve done is pushed for training. We’ve had a grassroots group of people who are interested in providing good care to the transgender and non-binary community and we’re working toward having more ongoing collaboration and training for all the physicians and providers involved,” Taylor said.

Keck Medicine formally entered a strategic collaboration with the TransLatin@ Coalition in March to improve access to specialized care for the transgender community. Taylor said this partnership enables Keck Medicine to center the voices of transgender individuals, further developing a program to suit the community’s needs.

“[The collaboration] has been really helpful to make sure that we are centering the needs and voices of trans people in the community,” Taylor said. “We’ve held focus groups and [have] been trying to understand how we should be doing this care in a patient-centered and community-centered way.”

Riley Davis, a licensed marriage and family therapist and clinical instructor of the department of psychiatry and behavioral sciences at Keck Medicine, said Student Health excels at interdisciplinary communication, allowing students timely access to the resources they need. 

“[In their counseling appointment], students will say, ‘Hey, I’m interested in going on hormones and how do I go about doing that?’ and I’m able to walk them through the process … and with  the student’s permission I can give a heads up to the medical provider and say, ‘Hey, this is what the student is going to be looking for and vice versa,’” Davis said. 

Keck Medicine and Student Health work together to offer student patients a wide variety of resources, and the community of doctors and counselors help advocate for students every step of the way. Altogether, the gender-affirming care programs both at Student Health and the broader Keck Medicine hospitals, Morisson said, represents the future of transgender/gender-nonconforming and LGBTQ+ healthcare.

“Because of the passionate, incredible people we’ve got involved, I see USC as being a world class, gender-affirming care program,” Morisson said. “For anybody — for students, for adults — I really see us being a destination for care.”

Correction: A previous version of this story referred to the Keck Medical Center of USC as the Keck School of Medicine. The Daily Trojan regrets this error.