When therapist Rene D. Czerwinski, LMHC, NCC, learned that almost half of transgender Americans attempt suicide in their lifetimes, her strong commitment to providing excellent care to transgender patients was reconfirmed. “That’s way higher than the national average for any other group. It’s a shocking number,” she says.

Rene’s practice at Pacific Medical Centers is underpinned by a key message: you are not alone, and there is support. Rene has pursued specialized training and certification in transgender care. At PacMed, she works with other health care providers who are open to continuous professional learning and committed to team care for their patients.

Rene works with transgender people as well as their parents. Parents of transgender children need to know they are not alone and that there are people out there who understand what they are going through.

The Need for Unified Services

In an international study published by the National Institutes of Health,* the rate of attempted suicide by transgender persons ranges from 32 percent to 50 percent around the world. Transgender people also face increased risk of discrimination, bullying, and violence, plus the loss of their support systems if rejected by family, friends, and the larger community. The police, health care providers, and other service providers often don’t have training or knowledge to provide high quality care to transgender people. All of these, of course, can influence the well-being of transgender people.

Rene sees a need for transgender services, a care area that she feels is not well understood. “Being transgender is not an illness,” she says. She explains that the emotional struggles of people who are transgender are often related to social anxiety, fear of rejection, self-image, and body image. This is part of what Rene helps patients, family, and communities understand. Rene knows firsthand what family members might need to know during transition: her child is transgender.

Respectful Mental Health Support

For clients who are transgender or exploring, Rene emphasizes that being transgender doesn’t mean anything is wrong with you. “We need to remove the stigma that being transgender is a mental health issue or an illness,” Rene says. “By doing so, we can see that the anxiety and depression that get attached to being transgender are related to the fears about how others will react or how sometimes our bodies don’t match what we want them to be.”

Clients who are considering transitioning, with treatments ranging from hormones to surgeries, may need the services of not only physicians, surgeons, and a counselor, but also a psychiatrist. Together, these professionals can make sure that insurance qualifications are met and provide letters and other documentation. They can help research support resources and care options and provide guidance during the process.

Your Body, Your Choice

Rene’s experience and training has heightened her awareness of how to create an accepting space for her patients. “It’s important for a caregiver to come on board with the patient—to not try to tell them how or what to feel,” she explains.

Therapy is a place to explore where a person is now and their desires for the future. Transgender care encompasses everything from small changes to big shifts. A transgender person doesn’t—and shouldn’t—have to know their destination immediately to receive excellent care.

“I remind my patients that everybody is going to look different. We don’t have to know that this is exactly how we want to look. Maybe you want to be somewhere in the middle,” says Rene. “We’ll find what works best for you because it’s your body, your choice.”

The Care at PacMed

Transgender people get to choose the right path for their personal journey. They need physicians who support them through the process—“in whatever stage you’re in and whatever stage you want to go to,” adds Rene.

Primary care physicians are a good starting point. When meeting a new provider, it’s important to be open about yourself, ask questions, and listen and watch how the provider responds. A good primary care doctor should be able to provide culturally competent care so that you feel comfortable and safe sharing who you are.

“One of the things I really like is when a physician feels free to ask questions, to consult with me and other providers, to learn what they need to know about this person. That’s a good sign,” says Rene.

At PacMed, you will have a point person to coordinate your care. Your team will communicate and consult with one another to keep each other on the same page with your goals. We want you to experience a unified approach to your care.

Rene D. Czerwinski, LMHC, NCC, practices Behavioral Medicine at the Pacific Medical Centers clinic in Totem Lake and is also a Board Certified Transgender Therapist through International Transgender Certification Association in Florida. PacMed offers licensed therapists and psychiatrists, an Endocrinology team and more than 60 board-certified primary care providers for adults at 10 clinics in the Puget Sound region.