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As part of NYC Pride Week 2014, NY1 examines some of the issues facing the city's transgender community.

Pride Week 2014: For Transgender Individuals, Competent Medical Care is Scant

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In today's installment of Pride Week 2014 coverage focusing on the transgender community, NY1's Erin Billups takes a look at access to health care—or the lack thereof.

Gaining access to health care has been an uphill battle for many transgender individuals.

The Medicare ban against sex-reassignment surgery was lifted last month and more and more are gaining access to care through the Affordable Care Act.

There's still a lag when it comes to culturally competent medical care, however.

"What good is all that access to care if we don’t have surgeons who can provide that care? In the United States, there really are still are relatively a hand full of surgeons that can do the genital surgeries," says Dr. Barbara Warren of Mount Sinai Beth Israel LGBT Programs & Policies Director.

In New York there are no doctors who perform full sex-reassignment surgery; nor does the state's Medicaid program cover it or hormone therapy.

California is one state that covers transition related care, but there's a catch.

"There’s a two year waiting list, because there are only two surgeons in the whole state of California that know how to provide that care," Warren says.

It's just an illustration of the unmet need, says Warren.

"They want to go into a setting where they know that they’re going to be treated not only with respect, but appropriately and competently," she says.

"The gender is between the ears, and not between the legs, so to speak. So I think that that's one of the biggest misconceptions—that people cannot identify with the gender without having hormone or surgical treatment," says Dr. Zoe Rodriguez, Vice Chair of Mount Sinai Beth Israel OBGYN Operations.

Rodriguez works with Dr. Warren and has helped train her colleagues, residents and staff on how to address the needs of transgender patients.

"They have been victims of verbal abuse, physical abuse. They may lack family support, so there's a lot to really touch upon. You're not just removing the uterus and ovaries; you really need to make sure that you're looking at the patient as a whole," Rodriguez says.

It's also the little things, like making the bathrooms gender neutral, that help create a welcome environment for transgender patients.

"Putting LGBT education pamphlets out in the waiting room—little things like putting the rainbow sticker has worked to make patients feel more comfortable," Rodriguez says.

Similar LGBT-focused care is cropping up at other institutions, including the city's hospital system, which is expanding its own initiative.

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