We sat down with Ben Barenberg, MD, FPMRS, an Oklahoma-City based urogynecologist, to get his perspective on providing comprehensive care to all patients in a state where gender-affirming care is banned. His practice promotes a safe and comfortable space to be open with all things related to gender identity, but with recent limitations, we wanted to understand what that means for his practice and patients.
First, Can you tell us about yourself, how you decided to be a Urogynecologist and what that means, how it is different from an OB or GYN, and why this profession is important to you?
My name is Ben Barenberg, MD, FPMRS, and I am a urogynecologist serving Oklahoma City and the surrounding communities. I attended medical school at the University of Texas Medical Branch. During clinical rotations in medical school, you rotate through all of the major services, including OBGYN. I really enjoyed my OBGYN rotation and felt extremely comfortable with the resident and attending physicians I worked with while on rotation. No other rotation gave me those feelings, so I pursued a residency in OBGYN at Loyola University Medical Center in Chicago. Loyola has an internationally known Urogynecology program, and I was lucky enough to be mentored by these physicians, which drew me to the field.
After finishing a residency in OBGYN, I chose to specialize in urogynecology. Urogynecology is essentially a hybrid between urology and gynecology. We focus on issues of the lower urinary tract and pelvic floor. This includes conditions such as pelvic organ prolapse, urinary and fecal incontinence, and birth injury correction. My practice also provides full-scope gynecologic services and menopausal management.
Urogynecology as a career is important to me because it allows me to positively impact women’s quality of life daily and to advocate and use my position to elevate my community through advocacy in women’s health.
Can you share your perspective on the importance of gender inclusivity in the field of OB/GYN/UROGYN and healthcare in general?
My job as a physician is not to judge people for how they wish to live their lives publicly and privately. My job is to provide excellent healthcare to anyone seeking help in my practice. In the setting of pelvic and sexual health, gender inclusivity is paramount. While a patient may present outwardly as a male, this same male may not have male genitalia. In this case, I still need to offer all necessary screening, including pap smear, STD screening, etc. Without establishing a safe space for patients to be open and honest with their gender, sexuality, health, and wellness, I would not have the opportunity to help in my full capacity, as one of the largest pieces of medical history is missing.
In light of the restrictions on gender-affirming care in Oklahoma and other conservative states, how do you approach providing care for transgender and non-binary patients?
I just approach these patients in the same manner as any other patient. While I may not be able to provide “gender-affirming care,” I can still be their advocate and provide yearly screening physicals, STI screening, acute care visits, etc. Providing a safe and comfortable space to be open with all things related to gender identity and healthcare translates to better overall health for these patients.
Have you faced any challenges or pushback from patients or colleagues regarding your inclusive approach? How do you handle these situations?
I am extremely vocal and forward with who I am and what I believe. Take a look at my social media; there is no question of my position on gender, sexuality, feminism, racial inequities, etc. I am not every patient’s cup of tea. If you don’t like my vibe, it is probably best you aren’t in my tribe. I live in a state that is ultra-conservative. For those colleagues who push back against the care I am providing; depending on the context of the conversation depends on how I respond. If there is a chance for education, I will approach the situation with the goal of teaching. If it is obvious they are not interested in engaging in conversation and expanding their mind, I just ignore them (unless they are being a bully). “Lions don’t lose sleep over the opinion of sheep.”
What advice do you have for other OB/GYN/UROGYNs or healthcare professionals who want to be more inclusive in their practice, despite practicing in conservative areas?
Don’t worry about what others in your personal/professional friend circles say about what you are doing. If you do right by people, the rest will fall in place. Stay true to yourself and your mission to provide high-quality care regardless of gender, race, and sexuality. If you want to be in this professional space that is frequently politically charged, be comfortable being uncomfortable because people will continually try to change your mind. Have thick skin and use your platform for education, social equity, and inclusivity. Little by little, you will begin to change the culture of healthcare for the better.
What advice do you have for patients who are seeking gender-affirming care in restrictive states?
In states that have made gender-affirming care criminal for physicians, I encourage patients to seek care from neighboring states. For those patients seeking routine screening exams after transitioning (or before), IE, female to male without bottom surgery, finding a physician in your community that makes you feel comfortable and safe when providing your complete history is paramount. Ask around to local friends in the community or take to google to try and identify who these doctors are. I try to make my opinions public on all social media and digital platforms so that people know my office is safe.
How do you educate yourself and your staff on current research and best practices related to gender-affirming care, especially when faced with restrictions or limitations?
I have a very small staff and tend to attract nurses and medical assistants that think similarly to me. Finding current research on gender-affirming care is the same as any medical condition. I research pubmed.gov and look for new articles and publications that are pertinent to these patient groups. I also follow the WPATH website and journal for cutting-edge research in this field. There are no restrictions that limit my ability to educate myself and others.
What is one thing you wish people knew about gender-affirming care?
I want people to know that regardless of gender, sexuality, race, etc, you are entitled to equitable, high-quality healthcare. We are in a sad time in our society’s history where these basic rights and liberties are being erased, providing nothing but a social and financial detriment to the patient and community at large. Find your medical allies. Leverage them. Together we can move the needle.
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