Nov. 2, 2020 – Patients brave South Florida traffic for upwards of an hour to reach the clinic of pediatric endocrinologist Lisa Kenigsberg Fechter, M.D. ’09, where they not only find the care they need but also a shoulder to lean on.
Kenigsberg Fechter specializes in the care of transgender youths and teenagers, a patient population that commonly faces barriers to access to health care, a lack of education from care providers and misunderstanding from their own communities. For these reasons and more, Kenigsberg Fechter works to create a setting at the Broward Health Transgender Clinic in Coral Springs where patients and their families can feel free to discuss their experiences and their plans for the future.
“It’s important for patients to know we have an understanding, supportive and welcoming environment. We have open minds, and we learn what our patients need to be healthy both mentally and physically,” she says. “If your patient doesn’t trust you, it’s hard to get the full picture, which in turn makes it hard to properly diagnose and treat them.”
Kenigsberg Fechter, who also serves as the medical director of pediatric endocrinology at Broward Health, works with young people who may be experiencing gender dysphoria, a feeling that their changing bodies are not matching up with their gender identity. These patients come to Kenigsberg Fechter to inquire about gender affirming care, which can involve puberty blockers or cross-gender hormones. Puberty blockers are reversible and postpone changes caused by puberty. For older teens already undergoing or past puberty, cross-sex hormones help patients develop sex characteristics to match their gender identity.
The first step to gender affirming care, however, is learning more about each of her patients individually, says Kenigsberg Fechter.
“This is not a ‘one-size-fits-all’ treatment. It’s part of the art of medicine. We tailor treatment based on what the patient needs,” she says. “Any decisions we make have to be coordinated with the patient, both parents and a mental health professional. It can take a few visits until we get on the same page in terms of what is best for the teenager.”
At her clinic, which serves a growing patient population of about 15 teens, Kenigsberg Fechter works closely with a social worker to conduct mental health screenings and develop an extensive list of area resources for her patients to navigate the medical sphere and get the comprehensive care they need.
“We’re building a network to guide patients through whatever they may need for medical care,” she says. “We know that patients who are transgender have more difficulty accessing care. They have trouble finding providers experienced or comfortable in providing transgender care, or they’ve had a bad experience in the past, so they will postpone the care they need.”
During her days as a UF medical student, Kenigsberg Fechter learned important lessons on the art and science of medicine that have remained close to her heart throughout her training and career. After receiving her medical degree, she completed an internship and residency in pediatrics at the New York University School of Medicine and went on to a fellowship in pediatric endocrinology and diabetes at the Albert Einstein College of Medicine in the Bronx.
“At the UF College of Medicine, there was a big emphasis on treating the person, not the disease, as well as the importance of communicating, relating to and being kind to patients. The bedside manner that was taught was one of the most important things I learned and certainly helped me in this field,” she says.
Her classmate, fellow South Florida-based pediatric endocrinologist Lital Dardik Reitblat, M.D. ’09, remembers Kenigsberg Fechter as a bright, compassionate student destined to provide competent patient care. The two had the opportunity to work together at a diabetes camp for children and teenagers and briefly worked at the same practice. Reitblat says she admires Kenigsberg Fechter’s trusting relationships with patients.
“She was a fun, caring and super smart medical student. I remember thinking even back then, ‘I would take my kids to see her for care,’” Reitblat says. “As a provider, the patients really love her. She’s very non-judgmental, which is so critical for the transgender teens she treats.”
Reflecting on Transgender Awareness Week, observed Nov. 13-19, Kenigsberg Fechter says her wishes for the next generation of physicians are that more and more providers take the time to learn the specific medical needs of the transgender population and recognize the enormous impact that gender affirming care can create for transgender youth and teens.
“I hope that this is a trend in our country and that more physicians will be able to care for this population,” she says. “I’m building relationships with these teens, getting to know their families and seeing how well they’re doing. It’s a rewarding experience to see that what we’re doing in this clinic is improving their health.”