Introduction

Introduction

At Cleveland Clinic, we are committed to offering all of our transgender and non-binary patients comprehensive and quality care. Our team is here to help navigate this process, in order to achieve lasting personal comfort with their gendered selves.

Our Transgender Medicine & Surgery Program offers routine medical care tailored specifically to patients’ needs, as well as transition-specific services including mental health support and therapy, gender-affirming hormone therapy and surveillance, and gender-affirming surgery.

Cecile Ferrando, MD, MPH
Cecile Ferrando, MD, MPH

Outcomes

Outcomes

“Our mission is to provide culturally competent gender affirming care and routine health care to transgender and gender fluid individuals. Our team members strive to serve our patients in the best way possible, and we do all that we can to make them feel comfortable and safe in our facilities. We applaud all patients for being brave enough to walk through the door, and will work as a team to help them reach their goals.”

Healthcare Equality Index

National research has shown that lesbian, gay, bisexual, and transgender (LGBT) patients are at increased risk for substandard, insensitive, or even abusive care due to stigmatization. This has led to a number of inequalities in the delivery and quality of healthcare to members of this group, which include:

  • Patients are more likely to delay needed regular medical care.
  • LGBT individuals are more likely to be dependent on alcohol, tobacco, or drugs.
  • Gay men and transgender patients are at higher risk of sexually transmitted infections, including HIV.
  • Lesbian women are more likely to be overweight and are less likely to have regular cancer screenings.
  • Youth are more likely to experience significant mental health problems, have a higher risk of suicide, engage in risky behaviors, and become the victims of violence.
  • Elderly LGBT patients are at risk for poor social support due to stigmatization.

We strive to decrease healthcare disparities through education, training, and the delivery of world-class health care to LGBT patients.

Since 2016, The Human Rights Campaign has recognized Cleveland Clinic hospitals for inclusive, culturally competent care.

The Human Rights Campaign's Healthcare Equality Index is a national benchmarking tool that evaluates healthcare facilities for their dedication to the equitable treatment and inclusion of their LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning) patients, visitors and employees.

Services

Services

Below are the services we currently provide for our transgender patients. We offer comprehensive care through a multi-disciplinary team of providers that are housed amongst our many institutes at Cleveland Clinic.

Fellowship Overview

Fellowship Overview

The Transgender Medicine & Surgery Program is a multidisciplinary program that includes the following institutes at Cleveland Clinic: Women’s Health, Medicine, Adult and Child Psychiatry & Behavioral Health, Pediatrics, and the Center for Bioethics. The entire fellowship will be divided into twelve one-month rotations.

While the focus of the program will be on surgery,  fellows will graduate with a comprehensive understanding of the medicine and mental health components of transgender care. Fellows will also have exposure to both adult and pediatric patients.

Genital Affirmation Surgery

This rotation enables fellow to become competent in reconstructive surgery techniques allowing the trainee to perform genital affirmation procedures independently once the fellowship is completed.

Transgender Medicine

The fellow will care for transgender patients seeking transition-specific medical services as well as primary care in a family health setting. The fellow will become competent in the medical care of transgender patients, and have an in depth experience seeing patients requiring transition-specific medical services as well as primary care.

Pediatric Endocrinology

The purpose of this rotation is for fellows to gain experience caring for transgender patients in Pediatric Endocrinology. The fellow will learn how to assess pediatric and adolescent patients who present for management of gender dysphoria and medical transition.

Adult Psychiatry

The Adult Psychiatry rotation will expose fellows to the mental health aspect of transgender care.

Physical Therapy

The purpose of this rotation is to learn how to manage postoperative transgender patients from a physical rehabilitation perspective after they have undergone genital affirmation surgery.

Plastic Surgery and ENT Surgery

The Plastic Surgery and ENT Surgery rotation is to expose the fellow to other types of gender affirming surgeries, including facial feminization, tracheal and vocal cord surgery, and breast surgery (mastectomy and augmentation).

Research

The purpose of the research portion of the rotation is for fellows to study transgender care using various study methodology, under the supervision of a research mentor. One day each week will be protected for research.

Educational Requirements

Educational Requirements

Female Pelvic Medicine and Reconstructive Surgery Case Conference

The fellows and faculty participate in a monthly M&M case conference for all urogynecology cases. At this conference, the fellow will present any challenging transgender surgical case and the goal is to facilitate group discussion to learn how to approach these types of cases.

Pelvic Floor Conference

The Pelvic Floor Conferences are attended by the Urogynecology, Female Urology, Colorectal Surgery faculty and their fellows and residents, along with interested members of the Departments of Biomedical Engineering, Quantitative Health Sciences and Physical Therapy. These conferences include subspecialist guest lectures, journal club, and case conferences. Fellows are asked to moderate the monthly journal clubs. Recent topics have included: diagnosis and management of vulvar disorders, assessment and treatment of chronic pelvic pain, management of mesh complications, transgender surgery, postpartum perineal care, surgical planning for pelvic organ prolapse, updates in treatment for urinary incontinence.

OBGYN & Women's Health Institute Grand Rounds

The fellow participate in weekly departmental Grand Rounds. Included in these conferences are monthly GYN Quality Assurance and Improvement meetings. Fellows actively participate in these conferences and present all pertinent patient materials.

Adult Transgender Team Meeting

The fellow will be required to attend the Transgender Adult Team’s monthly meeting. The fellow will be responsible for case presentations and will take an active role in discussing care plans for patients seeking gender affirming care.

Quarterly Adult and Pediatric Multidisciplinary Transgender Team Meeting

The fellow will also attend the quarterly Adult & Pediatric Multidisciplinary meeting that is intended to provide continuing education in didactic and journal club format to all members of the adult and pediatric teams. Fellows will be responsible for case presentations, literature reviews and leading journal club throughout the year.

Staff

Staff

Cecile Ferrando, MD, MPH
Cecile Ferrando, MD, MPH
Director of Transgender Surgical Services; Program Director, Transgender Surgery & Medicine Fellowship
Henry Ng, MD
Henry Ng, MD
Associate Staff
Elizabeth Dimmock, CNP
Elizabeth Dimmock, CNP
Certified Nurse Practitioner
Paul C. Bryson, MD, MBA
Paul C. Bryson, MD, MBA
Director, Cleveland Clinic Voice Center; Head, Section of Laryngology
Julia Cartaya, MD
Julia Cartaya, MD
Pediatric Endocrinologist; Endocrinology Head, Thyroid Head and neck Oncology and Pediatric Endocrine Center (Thyroid HOPE)
Tracy Hull, MD
Tracy Hull, MD
Section Head
Fellows

Fellows

Kavita Mishra, MD
Kavita Mishra, MD
Transgender Surgery & Medicine Fellow, 2020-2021
Female Pelvic Medicine & Reconstructive Surgery
Stanford University

Frances Grimstad, MD
Frances Grimstad, MD
Transgender Surgery & Medicine Fellow, 2021-2022
Pediatric & Adolescent Gynecology
Boston Children's Hospital

Apply

Apply

Cleveland Clinic Transgender Surgery & Medicine Fellowship, 2022-2023

We are excited to announce that we are currently recruiting our third Transgender Surgery & Medicine fellow at Cleveland Clinic in Cleveland, OH. We are seeking candidates who have at a minimum completed a residency in Obstetrics & Gynecology, and preferably, have fellowship training in either Female Pelvic Medicine & Reconstructive Surgery or Pediatric & Adolescent Gynecology. We are happy to review applications from individuals currently finishing their last year of fellowship or residency, as well as individuals already in practice.

The fellowship is a one-year multidisciplinary experience. At the end of the fellowship, the graduating fellow will be competent in performing genital affirmation surgery for trans-feminine and masculine individuals. The fellowship also includes an in-depth exposure to other gender affirming surgeries such as facial feminization surgery, vocal feminization procedures, and both masculinizing and feminizing chest surgery. The fellow will also spend time with our mental health, pediatric, and medicine specialists and will graduate with a comprehensive experience caring for transgender patients seeking gender affirming care.

Candidates should have a serious interest in incorporating gender affirming care in their surgical practice.

Deadline for applications is Friday October 29, 2021. Interested applicants should send the following to Crys Draconi, [email protected]:

  1. Updated CV
  2. Personal statement
  3. Two letters of reference – one should be from an individual who is in a supervisory role (ie. Program Director, Chairperson)

Invitations for our interview day, scheduled for Friday November 19, 2021, will be sent out by Friday November 5, 2021.