Visiting the Kaiser Permanente Transgender Member Care Service, Kaiser Permanente Los Angeles Medical Center

Kaiser Permanente LAMC View on Flickr

The signs aren’t even fully unveiled, at the beautiful new Kaiser Permanente Los Angeles Medical Center (@KP_LAMC) in the Hollywood neighborhood of Los Angeles, California. We found ourselves here because we asked to be. For people in the Kaiser Permanente non-profit health system, including me, this is an iconic place. It opened in 1953 and now includes 900 physicians and 6000 employees – it’s almost as large as an entire region of Kaiser Permanente (or Group Health Cooperative, where I came from).

We came here, myself and Melanie Hiller, the President of KP Pride, lesbian, gay, bisexual, transgender, intersex, queer employee resource group of Kaiser Permanente Mid-Atlantic States, to learn about the care of people who are transgender. Anna Pitinyan, RN, BSN, was our teacher – she is the Transgender member care coordinator for Kaiser Permanente Southern California, which serves close to 4,000,000 members.

When I was here for the first ever LGBTQI Health Symposium (see: Clinicians from the future practice the medicine of inclusion – Kaiser Permanente LGBT Health Symposium | Ted Eytan, MD), Anna’s role didn’t exist yet, and the room I was in was filled with nurses, physicians, and members learning together how to support transgender person health. Filled.

Now, 11 months later, transgender person health care is maturing into a service that guides our members through the transition process, in the context of a larger United States health system that is still deciding whether it wants to take care of these individuals. It was great to see.

We spent the day in the Endocrinology medical offices, where new consultations for hormone therapy happen, and briefly shadowed C. Scott Thomas, MD, and Jill Silverman, MD. One of our faculty from last year’s course, Tisha Baird, MD  stopped in to say hello.

One one level, I didn’t see much different here than I usually see in a Kaiser Permanente medical center – Permanente physicians and nurses using the latest technology, engaging with their peers and colleagues across specialties, oriented toward the best outcome for our members/patients. The quote I usually make applies here too – our doctors and nurses sometimes don’t realize how advanced their care is, because it is normal to them.

On another level, I observed an organization at a nidus of change, as an arranger and provider of care that hasn’t been embraced by the medical or nursing professions previously, and now, in California, it’s part of what we do. Anna showed us how she helps members navigate through the transition process. She is becoming known in the community, and she knows where members can get accurate information during a potentially confusing time.

I asked her at the end of our visit if she considered herself and ally. She said yes. This is what I find when I meet people who are providing heath care for this population – another expert is created, another professional in their professional and personal community who is changing attitudes, eliminating bias, producing health for the entire LGBTQI community, far beyond what they do in their professional role. It’s happening.

And by the way, yesterday was another reminder of the role that nurses play in the leadership of a modern health system. There is one. It’s really important. Always remember to shadow nurses when you shadow physicians, Kaiser Permanente happens to have 49,000 awesome ones.

Most physicians today will relate that the care of people who are transgender is not included in their curricula. That’s changing, fortunately (see this paper as evidence); until then, doing this well requires curiosity and an interest in promoting the health of everyone equally, because as the brand new walk in front of the hospital says, everyone matters. I think the walk says it better than that.

“You Matter” – Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA View on Flickr

We’re here as part of the Kaiser Permanente 2nd Annual LGBTQI Health Symposium, which is a place where we meet others who are practicing the medicine of inclusion. So cool that we get to meet fellow allies for good health working in our world class medical centers, too. 

What a difference just a year makes. I can’t wait to see what’s going to happen in just the next 12 months. The world is going to learn to love even better thanks to this work.

Thanks to Anna, Scott, Jill, Tisha, and all of the members, nurses, physicians and staff (special shoutout to our über host, PL Maillard, MPT, MHA, Assistant Medical Center Administrator) of the iconic Kaiser Permanente Los Angeles, we’re happy to be a part of the family!


Ted Eytan, MD