Workshops & Meetings

Day 2 - 10:45-11:30 am

Workshop: Multimodal Education Pilot for Cancer Screenings in an LGBTQIA+ Fellowship

Stephen Dunn, (he/him/his), DO, AAHIVS, Director of Medical Education Fenway Health

Jenny Siegel, (she/her), MD, HMS-Fenway Fellowship; Massachusetts General Hospital

Jenny Potter, (she/her), MD, Harvard Medical School-Fenway

Overview: The workshop begins with a brief didactic on cancer screenings in the LGBTQIA+ patient population, then relating this topic to the relevant milestones from the fellowship curriculum, transitioning to show brief snippets from our Casebook that address cancer screening in various LGBTQIA+ protagonists. Finally we will wrap up the workshop demonstrating how this topic is incorporated into Fellowship Seminars.

Objectives: 1). Review cancer screenings in the LGBTQIA+ population and how to incorporate this topic into fictional medical case. 2.) Review relevant fellowship milestone and discuss development. 3.) Demonstrate how this topic is incorporated into Fellowship Seminars


Workshop: Working with transgender patients who use non-prescribed/ self-sourced hormones for gender affirmation

Eli Goldberg, (he/him), MD, Harvard Medical School-Fenway Fellow

Overview: Many transgender people will use self-managed/non-prescribed hormones at some point in their lives (sometimes called "DIY HRT"). The 2019-2020 National HIV Behavioral Surveillance Among Transgender Women survey found that 19.7% of respondents had used nonprescribed hormones within the past year. This session will present a case of a transgender woman choosing to self-manage hormone therapy despite ready access to affirming medical care. We will discuss the range of reasons why patients self-manage hormones, and the clinical, ethical, and medicolegal questions that this raises for healthcare providers. We will also consider varying ideological frameworks to explore possible approaches to working with patients who self-manage hormones. The ultimate goal is not to present a single set of best practices, but to reflect critically on our own perspectives and assumptions about power, autonomy, and medicalization in gender-affirming care.

Objectives: 1. Explain potential factors that contribute to patients' use of self-managed/non-prescribed hormones for gender affirmation 2. Critically examine own and colleagues' experiences and perceptions about patients who self-manage hormones 3. Develop individualized, collaborative clinical plans for patients who have been self-managing hormones.


Workshop: ANCHOR trial and the new screening guidelines for anal dysplasia

Laurence Moore, (he/him) MD, LGBTQ+ Medicine Fellow, University of Wisconsin-Madison

Justin Temple, (he/him/his), MD, University of Wisconsin-Madison

Overview: Anal dysplasia and anal cancer are diseases that disproportionately impact people living with HIV and especially MSM living with HIV. Recently, advances in our understanding of the biology and epidemiology of anal dysplasia have led to the development of professional society guidelines for screening. A comprehensive understanding of the scientific background, screening tools, and definitive treatment options is important to situate medical providers’ understanding of this disease since the need and demand for screening currently exceeds capacity by orders of magnitude. In this session, we will review recent advances in the science of anal cancer screening and treatment in addition to the recently published IANS screening guidelines.

Objectives: By the end of this session, participants will: 1.) Understand key tenets of the biology and epidemiology of anal dysplasia. 2.) Describe the recently published anal dysplasia screening guidelines. 3.) Build a plan for the implementation of anal cancer screening into their practice or institution.


Workshop: Addressing Gender Affirmation in a State with Laws Banning Care

Kevin Niswender, (he/him), MD, Vanderbilt University Medical Center

Hayden Shafer, (he/him), MD, Assistant Professor, Vanderbilt University Medical Center

Overview: Given the legislative changes in Tennessee, adolescents who were receiving gender affirming hormone therapy were rapidly transitioned to adult care from a Pediatric Endocrinology practice. This has brought unique and unexpected challenges for new providers and a vulnerable, younger patient population. We will review institutional challenges related to these new laws and share our experiences.

Objectives: 1.) Understanding the impact of legislation on adolescents seeking gender affirming hormone therapy. 2.) Describe strategies for seamless patient transition into adult care, and lessons learned from an individual provider as well as a systems perspective. 3.) Share experiences on building a supportive healthcare infrastructure in the setting of legislative changes.


Workshop: Creating an Affirming Space for LGBTQ+ Patients in Middle TN

Chris Terndrup, (he/him), MD, Associate Program Director, Vanderbilt University Medical Center

Steven Allon, (he/him), MD, Vanderbilt University Medical Center

Overview: In middle Tennessee, cultural norms and sociopolitical biases can influence approaches to LGBTQ+ affirming care in clinical settings. To counteract these biases, we created an LGBTQ+ Inclusion Committee in a large, academic primary care clinic serving the region. This interdisciplinary, community-engaged committee served as platform to modify existing ambulatory workflows for affirming care. We will share our findings and discuss unique challenges to achieving equity in healthcare delivery for LGBTQ+ patients in the South.

Objectives: 1.) With a minority stress model framework, review inequities in healthcare delivery and outcomes for LGBTQ+ populations. 2.) Identify non-affirming care in ambulatory settings and describe a framework to advance equity in healthcare delivery. 3.) Seek out challenges and next steps to create affirming workflows in various clinical settings.