USC Verdugo Hills Hospital is at the forefront of providing gender-affirming care with the goal of addressing health care disparities faced by transgender individuals.
Gender-affirming surgical services at USC-VHH includes phalloplasty, vaginoplasty and gender-affirming facial surgeries. But the surgical director of the gender-affirming care program, Dr. Roberto Travieso, said that it is not all about the surgeries one can get.
“We provide comprehensive care for individuals seeking gender-affirmation procedures, but our services extend beyond that specific focus, as we address a wide range of health concerns, including routine procedures,” said Travieso. “Transgender individuals still need regular primary care visits, so our goal is to provide procedures and treatments that specifically affirm their gender identity, while also ensuring that their entire health care experience is inclusive.”
Although the program started about a year ago, the surgeries have just started this year. USC-VHH is one of the rarer community hospitals that provide these services. What also makes the program unique is the collaboration of the community itself.
“One of the things that was very important to me coming in was collaborating with the LGBTQ+ community and not just creating yet another program without engaging the community in meaningful conversations,” said Travieso.
The hospital partnered with The TransLatina Coalition, one of the largest trans-led organizations in Los Angeles, according to Travieso.
The hospital meets monthly with the organization to make sure that they get a chance to share their feedback on the program as it grows. The program is composed of physicians from several disciplines including family medicine, plastic surgery, gynecology, urology and otolaryngology. Specialists in voice, occupational and physical therapy are also available to patients, according to their website.
As far as age range for surgeries, Travieso said that he only sees adults and said that the youngest patient he’s had was 18 and the oldest was 60. The number of patients he’s had is still in the early stages.
“Our emphasis is not on achieving a specific number of surgeries. Our approach is to proceed at a steady pace, while making sure we’re very thoughtful about everything we do,” said Travieso. “While we have started scheduling surgeries, our goal is to ensure that every surgery is conducted with meticulous care and successful outcomes for our patients. My ultimate focus is always prioritizing patient well-being.”
As a member of the LGBTQ+ community, Travieso became interested in gender-affirming care early in his medical studies. He finds the need to clarify the controversy of having gender-affirming surgery.
“This is a conversation that comes up and it’s very fascinating, because I think it comes from those of us that don’t have this experience in life,” said Travieso. “It’s important to recognize that the decisions are not done on a whim. This is a lifelong journey.”
Travieso does admit that the transition surgery is mostly irreversible, but the number of patients he sees that have some sort of regret comes from the complications the patient has to deal with.
“Surgical regret is a commonly discussed topic in relation to gender-affirming surgery, but the rates of regret for gender-affirming surgery are actually exceedingly low,” said Travieso. “It’s not that people change their mind about who they are and decide to go back to an identity that is different from the one that they identified with when they had surgery. It’s that they regret having to deal with complications.
“In terms of regret rates among patients, when considering all of these components, it’s actually comparable or lower to other surgical procedures, like breast reconstruction or gallbladder removal,” he added.
The process itself to get to the stage of thinking about surgery is a long one, Travieso said.
“By the time [patients] come to a surgical consultation, they have met a number of medical providers, mental health providers and health care workers and professionals,” he said.
To learn more about the Gender-Affirming Care Program, visit keckmedicine.org/centers-and-programs/gender-affirming-care/.
First published in the July 8 print issue of the Glendale News-Press.
