Ep. 284 Integrating Gender Affirming Care Into Urology with Dr. Eric Walton
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How did Dr. Eric Walton find his path into reconstructive and gender-affirming urology?
Giving someone a PNL prosthesis because they have erectile dysfunction is gender-affirming care. But specifically, things for gender-diverse persons can definitely be done by a general urologist. Urologists can do orchiectomies for trans women who are interested in that as either a starting point. for their surgical care or even a final surgery for themselves. They may not be interested in a vaginoplasty or a vulvoplasty going forward. A lot of general urologists also offer testosterone therapy to their cisgendered patients, and that's certainly something that you can offer to transgender patients as well.
Welcome to Backtable Urology, everyone. I'm George Koch from The Ohio State University, and I'm really excited to introduce one of my partners at The Ohio State University, Dr. Eric Walton, today to discuss gender surgery and its growing place in urology. Thank you so much for being here, Eric. I really appreciate it. Oh, yeah. Happy to be here. Thanks so much for the invite. Of course. Of course. Can you start by telling us a little bit about your path to reconstructive urology and gender surgery?
Yeah, sure. So, well, to be honest, I didn't think I was going to be a surgeon, but then I fell in love with the OR and all the technical aspects of surgery. And actually, my first exposure to urology was pediatric urology, and there's a lot of overlap there with reconstructive urology. And as I was in medical school and residency, ultimately I found that what I most enjoyed about urology is improving people's quality of life and however that might be defined for a patient. And I found that reconstructive urology was really the perfect fit to provide that care to patients. With respect to like gender surgery specifically, that kind of brought together a... interest of mine that was there before I even started urology, which was an interest in health disparities and access to care.
And when I was looking for opportunities as a resident to work in that space, I discovered gender-affirming surgery. We didn't have any exposure to it in residency, but I thought it was a good opportunity Marriage of the technically interesting work of surgery, improving quality of life for patients, and then working to expand access to care for underserved groups.
Okay. I hadn't heard that before. So from an access to care standpoint, can you talk a little bit about the gender diverse community and what troubles they face with access to care? I know we're skipping around a little bit, but since you bring it up, I think it's a really great point.
Yeah, absolutely. So, we know that gender diverse individuals, whether they identify as transgender, non-binary, or another identity, we know that they're generally underinsured. So, just getting access to care in general is a problem. And then from a surgical perspective, there's still not that many providers throughout the country or even worldwide who are offering this care. And so, they might have to travel outside of their state or outside of their country to even access that. So training to do this work by increasing the number of people who are offering surgery is increasing access of care for patients.
Yeah, absolutely. And hopefully a little later on in the conversation, um, I'd love to talk, um, a little bit more about, uh, ways that we can kind of expand access for these patients. One thing I was hoping to, for those listeners who maybe aren't urologists or who are medical students thinking about urology or who are urologists that trained, you know, a few years ago, you know, maybe when there were fewer gender surgeons, um, you know, spread throughout the country. I was hoping you could talk a little bit about what specialized training in gender actually looks like just so that we can kind of all be on the same page.
Absolutely. So like you mentioned, it totally depends on the person. If you're someone who is a little bit older than I am, there were not or there were no opportunities for formal training. So you would go and observe other surgeons who were doing this work already, or you go apprentice with them for a period of time and then bring these surgeries back into your practice.
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