LGBTQ+ Reproductive & Sexual Health Fellowship

• Gender-affirming care: All fellows will spend 1-1.5 days per week learning to independently manage gender-affirming hormone therapy for the hundreds of patients seeking care through the University of Michigan Comprehensive Gender Services Program (CGSP).  Fellows will begin the year by staffing clinics under direct supervision from program faculty but will eventually see patients in their own half-day continuity clinic. Fellows will also spend approximately 1 full day every other week in the operating room performing gender-affirming surgeries, including hysterectomy and salpingo-oophorectomy. For individuals with a strong surgical interest, training in vaginectomy procedures may be available. The program will offer exposure to a wide range of specialties and disciplines involved in LGBTQ+ reproductive & sexual health and wellbeing. The goal is not for fellows to be able to provide all of the following services independently, but rather to gain both a broad and deep understanding of the multidisciplinary services utilized by the LGBTQ+ community, including:  

  • Urology: Masculinizing and feminizing genital surgeries and urinary diversions

  • Breast / Plastic surgery: Chest surgery, implants, genital surgeries 

  • ENT: Voice feminization, tracheal shave, facial feminization procedures 

• Family building and fertility preservation: Fellows will spend time with faculty from the division of reproductive endocrinology and infertility learning about LGBTQ+ family building, including providing counseling on options for family building, third-party reproduction including the role of donor sperm, donor oocytes, donor embryos, and gestational surrogacy, assisted reproductive technologies (ART), and fertility preservation in the context of gender-affirming care. Fellows will also spend time on labor and delivery to provide a comprehensive approach to the obstetric journey for LGBTQ+ individuals and families.

• Sexual health: All fellows will gain expertise in LGBTQ+ sexual health, including workup of pelvic pain, contraception, STI prevention/screening/management (excluding treatment of HIV/AIDS), and management of disorders of sexual function, including desire, arousal, and orgasm.

• Psychosocial wellness: All fellows will gain exposure to the broad range of psychosocial services our interdisciplinary team of psychiatrists, psychologists, and social workers provides to the LGBTQ+ community.

A variety of elective opportunities are offered based on the fellow's professional interests, including participation in our interdisciplinary differences of sexual development (DSD) clinic, menopause clinic, vulva clinic, high-resolution anoscopy (HRA) clinic, HIV/AIDS clinic, addiction medicine, and clinical ethics.

To maintain skills, all fellows will have a general OBGYN continuity clinic 1 half-day per week and take 1 weekday shift on labor and delivery (L&D) every other week. Fellows will also take L&D call for 2 weekend shifts per month (day or night) and serve as our inpatient GYN faculty rounder for 2 weeks during the year, supervising the inpatient service and staffing consults. During their two weeks of GYN rounder duties, the fellow will not have any other clinical responsibilities.

Week 1

Week 2

*This is only a sample schedule, and the experiences and time dedicated will vary to ensure high quality and balanced clinical and research experiences.

Fellows are required to research or quality improvement project to be submitted to a national conference, as well as prepare a manuscript for publication. Fellows will have access to a variety of mentors within and outside the department of obstetrics and gynecology and are supported to pursue research that inspires them.

In developing their research skills, fellows will have access to a variety of Michigan Medicine resources, including workshops on research methodology and statistics and staff assistance for grant submission, statistics support, and manuscript copyediting. Fellows will also have access to a Professional Development Fund (PDF) which can be used for travel and lodging to academic conferences.

We seek to equip fellows with the necessary skills to become agents for positive change by providing formal training in advocacy and community engagement. Fellows will be invited to collaborate with the Women’s Health and Reproductive Disparities Collaborative (onWHARD) within the Department of Obstetrics and Gynecology, which carries out longitudinal community-engaged projects throughout the state. Fellows will also have opportunities to gain training in advocacy through formal educational programs such as the American Society for Reproductive Medicine PRIMED scholars program and ACOG Congressional Leadership Conference, through active participation in our Michigan Medicine LGBTQ+ Health Advisory Committee, and opportunities for collaboration with institutional, local, state, and national working groups or agencies.