Should You Get the COVID-19 Vaccine If You Are Pregnant?

If you’re pregnant, you likely have a lot of questions about whether it’s safe for you and your baby to receive a vaccine against COVID-19. In this Q&A, Jill Berkin, MD, Assistant Professor of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai, draws on her vast experience as a high-risk obstetrician—as well as her own pregnancy—to offer her perspectives on side effects, vaccines and breastfeeding, and how to decide if vaccination feels right for you.

“Pregnant women should weigh their personal risks of coronavirus exposure against their tolerance of the unknown regarding vaccination,” says Dr. Berkin, who received two COVID-19 vaccine shots during her second trimester of pregnancy. “Right now our information is limited, but all the information we do have suggests that COVID-19 vaccines are safe in pregnancy.” She suggests those with specific questions about their own situation consult with their health care providers.

Why did you get the COVID-19 vaccine?

 As a high-risk obstetrician I saw firsthand how pregnant women were affected by COVID-19. I also thought about my day-to-day exposure to the coronavirus through my work. I was more concerned about the known risks of infection than the unknown risks of vaccination, so my decision was easy.

Jill Berkin, MD

In general, do you think other pregnant women should get the vaccine and why?

It’s really important for pregnant women to realize that we don’t have data saying the vaccine is unsafe during pregnancy. Even though our data are limited, all of it points to the fact that vaccination is safe, and we don’t see any side effects specifically impacting the pregnancy itself. We haven’t seen any harm among women who were pregnant after receiving the vaccine in clinical trials.

In addition, each individual pregnant woman has to evaluate her own potential risk for exposure just like I did for myself. As a health care worker my exposures were great, so they outweighed any fears of the unknown with the vaccine. And of course, people who are pregnant may want to consult their own physicians for advice as well.

What are the risks and complications of COVID-19 and pregnancy?

Most pregnant women infected with the coronavirus will have symptoms similar to those who are not pregnant. The vast majority of pregnant women affected are asymptomatic. A large portion of the population has symptoms similar to a cold or flu, including muscle aches and fever. Then there’s a small portion of the population that has more severe disease that might require hospitalization. The data we have now comparing pregnant individuals to non-pregnant individuals shows that symptomatic pregnant women do have a slightly higher risk of a hospital admission, ICU admission, and even mechanical ventilation, but there’s no increased risk of mortality.

Would you say then that pregnant women are at higher risk of developing severe COVID-19?

While it’s hard to fully analyze, the data suggests that pregnant women are at increased risk for developing severe complications of COVID-19. But we have to remind ourselves that in general, pregnant women who become ill are more likely to present to their physicians than women of the same age who are not pregnant, and that’s because you see a doctor more often when you’re expecting. Doctors will also be biased towards admitting women who are pregnant and keeping a closer eye on them because there are two patients at stake.

For those getting the COVID-19 vaccine, what are some side effects to be expected?

The most common side effect that people report is soreness in the arm, similar to a lot of other vaccines. Afterwards some patients might experience mild cold- or flu-like symptoms for about 24 hours. This seems to happen more frequently with the second dose, which is three or four weeks after the first dose. Pregnant women, along with the rest of the population, can take pain relievers such as Tylenol after their vaccine shots to help alleviate some of those symptoms.

Do you think there’s an optimal time for receiving the vaccine during pregnancy?

We don’t have any research to suggest that there is an unsafe time to vaccinate during pregnancy. However, pregnant women might consider not receiving the vaccine during the first trimester. This is only because in general we avoid medical interventions in the first trimester, which is the period of “organogenesis” when the baby’s organs are forming. We don’t have data suggesting there are any negative effects of the vaccine on organ systems. But because we are dealing with a lack of information regarding COVID-19 vaccines and pregnancy—and out of an abundance of caution—perhaps delaying vaccination until the second or third trimester, if possible, could be beneficial.

What do you recommend about vaccination during breastfeeding?              

The vaccine certainly has no risks, and only potential benefits. We know that one of the most wonderful things about breastfeeding is that women pass antibodies through their breast milk to their babies. We don’t have much information specifically about antibodies created from COVID-19 vaccination being passed through breast milk. But we do have encouraging data about women who were infected with coronavirus itself forming antibodies and passing those antibodies along through the placenta and through breast milk. So the benefit of being able to protect children against coronavirus when a vaccine is not currently available to children is a remarkable thing and a unique advantage of being a lactating mom.

Luciana Vieira, MD, who conducted the Q&A, is an assistant Clinical Prof of OB/Gyn and Reproductive Science at ISMMS and the Blavatnik Family Women’s Health Research Institute Scholar for 2020-2021. Dr. Vieira has been integral in creating a perinatal database to collect/analyze data on maternal + neonatal outcomes within Mount Sinai Health to improve care.

 

 

 

 

 

 

No Quality Without Equity: The 2021 Maternal and Child Health Equity Virtual Summit Proceedings

Elizabeth Howell, MD, MPP

“Systemic racism has taken an extraordinary toll on the health and wellness of Black women and babies. We are here today to develop actionable items to improve maternal and infant health equity.”

This powerful sentiment is how Elizabeth Howell, MD, MPP, Chair of the Department of Obstetrics and Gynecology at the Perelman School of Medicine and the University of Pennsylvania Health System, opened the Maternal and Child Health Equity Virtual Summit on January 12.

The five-hour summit was held on the New York Academy of Medicine Zoom platform and included featured presentations and panels of diverse members including leaders in medicine, nursing, community-based-organizations, and perinatal and maternal health research.

Dr. Howell, the previous Director of Mount Sinai’s Blavatnik Family Women’s Health Research Institute, partnered with the New York Academy of Medicine, the Institute, and the University of Pennsylvania to establish this important educational summit as the final phase of her NIH-funded research investigating the contribution of hospital quality to racial and ethnic disparities in maternal and infant health. Dr. Howell co-chaired the summit with Danielle Laraque-Arena, MD, a senior scholar-in-residence at the New York Academy of Medicine.

Dr. Howell presented the findings of her research to the more than 450 attendees of the virtual summit, outlining the interactions between structural racism, system factors, clinician factors, patient factors, and community or neighborhood to influence racial and ethnic disparities in maternal and infant morbidity and mortality.

According to their findings, there were clear themes between hospitals that outlined high and low performance of maternal health outcomes. High performing hospitals had a stronger focus on standards and standardized care, stronger nurse-physician communication, and a higher awareness that disparities and racism may be present in hospital settings and could lead to differential treatments.

Dr. Howell’s group went further to analyze within-hospital disparities. After calculating similar risks of severe maternal morbidity for patients within the same hospital insured by Medicaid or commercial insurance, they found that Black women as compared with White women had higher maternal morbidity rates (after adjusting for insurance, obesity, etc.). Dr. Howell and her research clearly demonstrate the health care crisis for moms of color, and the rest of the day’s programming helped bring diverse voices to the conversation and plan action steps to reduce these disparities.

The summit was divided into three parts: Maternal Health, Infant Health, and the Mom-Baby Dyad, each with one featured speaker and a panel of diverse experts. The featured speaker for Maternal Health was  Karen A. Scott, MD, a leading OB/Gyn from UCSF School of Medicine, who outlined the “sacred birth” movement.

“Sacred birth is a radical attitude towards human births, specifically Blackness, Black bodies, and Black births. The movement advocates for safer, respectful more dignified and higher quality participatory birth care,” she said.

Dr. Scott powerfully stated at the summit, “We need to shift power to generate and disseminate knowledge of the QI space that has been usually excluded to hospital administrators and executives over to Black mothers, birthing people, community members and scholars.”

The Maternal Health panel, moderated by Wendy Wilcox, MD, (NYC Health+Hospitals) included Sascha James-Conterelli, DNP, (Lecturer in Nursing, Yale School of Medicine), Chanel Porchia-Albert (Founder, Ancient Song Doula Services), Natalie D. Hernandez, PhD, (Assistant Professor, Morehouse School of Medicine) and Dr. Allison Bryant, MD, (Massachusetts General Hospital). The panel discussed diversification of the labor and delivery workforce, anti-racist medical models, and quality improvement. Dr. Bryant stated one of the most salient quotes of the day: “No quality without equity.”

The second part of the summit, Infant Health, began with Dr. Howell conveying her research findings on infant morbidity and mortality. Dr. Howell led the next section of the summit: Infant Health Inequities.

“Very preterm births account for only 2 percent of all births but 53 percent of all infant deaths, and Black infants are three times more likely than white infants to be born very preterm,” she said. Based on Dr. Howell’s findings, up to 40 percent of the Black-White disparity in very preterm birth morbidity and mortality was due to the difference in which hospital the child was born in.

Jeffrey Horbar, President of Vermont Oxford Network, was the featured speaker and built upon Dr. Howell’s research, noting that white infants are overrepresented at high-quality hospitals in New York City and black infants are underrepresented at those same hospitals. Dr. Horbar’s theme throughout his presentation was clear: the importance of following through for patients.

“Our responsibility to NICU infants and their families extends beyond hospital walls, following through to address their social determinants of health, which will ultimately determine the health and well-being of infants and their families,” he said.

Dr. Horbar also outlined his organization’s new innovation grants to promote health equity, “Take Action to Follow Through,” which can jump start equity and quality improvement programs in NICUs around the country.

The Infant Health panel, moderated by Deborah Campbell, MD, (Albert Einstein College of Medicine) included Dr. Horbar, Teresa Janevic, PhD, MPH, Assistant Professor of  Obstetrics, Gynecology and Reproductive Science, and Population Health Science and Policy at Icahn Mount Sinai, and a member of the Blavatnik Family Women’s Health Institute, and Adrienne Mercer, EdD, (Northern Manhattan Perinatal Partnership). Panelists discussed paid-parent advisor positions to work with physicians, structural racism, and the significance of doulas in supporting birthing people. Dr. Mercer shared the sentiments of one of the women that her organization worked with. In describing her doula, the woman said, “Having a woman I can talk to made me feel supported and that I matter.”

The final part of the summit called “Mom-Baby Dyad” began with Jennifer Zeitlin, MA, DSc, an epidemiologist who has been a co-investigator in much of Dr. Howell’s research. She discussed how Black and Latina mom-baby dyads face a double threat, a domain in health care that needs actionable change.

Her research specifically showed that severe maternal morbidity is an independent risk factor for very preterm mortality. She stated that efforts to integrate and strengthen quality improvement in both obstetric and neonatal care at hospitals where Black and Latina women deliver may be a critical step to reduce the co-occurrence of disparities for maternal and child health outcomes.

The final panel of the day, moderated by Lynn Roberts, PhD, (CUNY), included Mary D’Alton, MD, (Columbia), Colette Sturgis (Urban Health Plan), and Jochen Profit, MD, (Stanford) who discussed their own institutions’ efforts to reducing maternal and child morbidity and mortality. Dr. D’Alton discussed the specific significance of maternal mental health as absolutely integral to the overall health of the mother, and Colette Sturgis, the Program Director at Urban Health Plan, discussed how their Maternal and Infant Community Health Center has adapted through the pandemic to support mothers.

Dr. Laraque-Arena of NYAM began the closing remarks of this important event, stating “We have a lot of work to do in deconstructing the entities that have supported inequities in maternal and infant health.”

And Dr. Howell concluded by summarizing action steps for the future, including improving workforce diversity, integrating Black and Brown women’s lived experience into health care, supporting doulas through Medicaid coverage, and engaging community members in quality committees and improvement. Dr. Howell encouraged leaders in executive and administrative positions to be proactive and vocal about these significant issues.

“It takes bold leadership to take a strong stance and say: we have to do better,” she said.

The New York Academy of Medicine has more information on the Maternal and Child Health Equity Virtual Summit, including PDFs of speaker’s presentations and a recording of the entire event.

Mahima Krishnamoorthi, BA, is the Clinical Research Coordinator at Blavatnik Family Women’s Health Research Institute, where she develops and fosters her passion for women’s health and reproductive justice.

 

 

Marking Cervical Health Awareness Month

January is Cervical Health Awareness Month, and in celebration we are resharing an interview with Whitney Lieb, MD, MPH, in which she answers some frequently asked questions on cervical health.  

During the video Dr. Lieb provides useful gynecological information including what is the cervix, what is human papillomavirus (HPV) infection, and what are recommended screening guidelines for cervical cancer. The information provided is based upon The American College of Obstetricians Gynecologists Frequently Asked Questions.  

Although the number of cases and deaths from cervical cancer has decreased significantly over the past 40 years, it is still the fourth most frequent cancer in women around the world and significant racial health disparities persist.  Black, Latina, American Indian, and Alaskan Native women continue to be disproportionately affected by cervical cancer compared to white women. The mortality rate from cervical cancer in Black women is twice that in white women.

Dr. Lieb highlights that education, regular screening, the HPV vaccination, and follow-up after an abnormal Pap results are ways to help reduce these disparities.

Whitney Lieb, MD, MPH, is the Women’s Health Scholar with The Blavatnik Family Women’s Health Research Institute. She is also an Assistant Professor in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai. Her interests include cervical cancer screening and prevention, maternal mortality, and reproductive health in the United States and globally.

Amy Balbierz, MPH, is a program manager in the Department of Population Health Science and Policy and for The Blavatnik Family Women’s Health Research Institute. She has worked alongside Elizabeth Howell, MD, MPP, founding Director of The Blavatnik Family Women’s Health Research Institute at the Icahn School of Medicine at Mount Sinai, on her NIH and RWJF funded research for the last 10 years.

 

Smiling for Two—The Importance of Oral Health in Prenatal Care

Pregnancy is a special time in the life span to secure the oral health of mothers and their young children. Pregnant women often experience changes in oral health due to increased inflammatory response to dental plaque. Uncontrolled and untreated, inflammation in the gums and bones in the mouth (periodontal disease) can induce a systematic inflammation response, affecting the health of both mom and baby. Prior research suggests a potential association between periodontal disease in pregnant women and adverse birth outcomes. Additionally, pregnant women with untreated dental caries—tooth decay—can increase the risk of dental caries for young children by transferring caries-generating germs like Streptococcus mutans, from her mouth to the baby’s mouth. In young children, dental caries may require extensive treatment involving sedation or even general anesthesia if the child cannot tolerate chair-side procedures. The costs associated with such procedures often create major financial and psychosocial burden in families.

Oral Health is Prenatal Health

Preventive, diagnostic, and restorative dental procedures are safe throughout pregnancy and effective in improving and maintaining oral health. However, more than half of mothers do not receive periodic dental cleaning during pregnancy. Education, race/ethnicity, dental insurance, and household income have all been associated with the usage of dental services and oral health outcomes. Some women are misinformed that all dental treatments should be delayed after delivery, and sometimes they worry about potential adverse effects of routine dental care to the fetus. Given the importance of oral health during pregnancy for the health and well-being of mothers and their babies, the American College of Obstetricians and Gynecologists (ACOG) in 2013 stated that ‘women should routinely be counseled about the safety and importance of oral health care during pregnancy, and should be referred for dental care as would be the practice with referrals to any medical specialists.’ ACOG made it clear that oral health is an integral part of prenatal care. Healthcare providers from both medicine and dentistry acknowledge that preventive, diagnostic, and restorative dental treatment is safe throughout pregnancy and is effective in improving and maintaining oral health.

As a mother of a young child and pediatric dentist, I believe oral health knowledge among pregnant women is the key to securing the oral health of both women at childbearing age and their young children. In 2014, I was a pediatric dental resident at The Mount Sinai Hospital ; I was also pregnant. I had begun a prenatal oral health education program with prenatal coordinators in East Harlem and the Bronx that integrated oral health education and care coordination into CenteringPregnancy, their prenatal group oral health education model.  Before I joined Mount Sinai in 2014, I was involved in the publication of the national oral health guidelines for pregnant women as a dental officer at the Department of Health and Human Services. Three years after this publication, I found that the majority of clinicians, both physicians and dentists, were not aware of these guidelines. Most of my pregnant friends in prenatal groups were told to go to the dentist after delivery, unless they had a dental emergency. I was surprised by the gap between science and practice and decided to investigate the root causes. Three levels of issues generated this gap: provider training, patient education, and practice coordination.

Bridging the Gap to Improve Prenatal Dental Care

First, dental providers, primary care providers, and administrative staff need to be trained based on the most updated guidelines to advance the oral health of expecting mothers and their babies. Pregnancy should not be a reason to avoid necessary dental care, but rather it needs to be seen as a teachable moment, empowering mothers to secure their oral health as well as their baby’s healthy smile. With the current national guidelines and published best practices, we can achieve this.

Secondly, we need to acknowledge that mothers, not the pediatric dentist, are often the primary care providers. They decide what to put in the bottle, which snacks to give, and how often to brush their child’s teeth. Because of this, pregnant women and mothers should be educated on the relationship between mother’s oral health and baby’s oral health and be encouraged to receive necessary dental care, and practice home oral hygiene activities along with a low-sugar diet.

Finally, we need to build a system that is meaningful and sensible to pregnant women and connect them to oral health care. Even if care providers know the importance of oral health and are willing to provide appropriate and necessary dental services and referrals, and even if pregnant women value oral health for themselves and their babies, low-income pregnant women may not be able to access dental services without system-level support. New York is one of the states that provides comprehensive dental care for pregnant women enrolled in Medicaid. However, how many of these low-income pregnant women actually know about this coverage?  How many know how to find dental facilities who accept their insurance during pregnancy?  These are the questions we need to consider. Coverage is important, but patients may need help in the interpretation and utilization of such coverage.

How COVID-19 Has Impacted Dental Care

Currently, we have a new challenge – dental care during and after the COVID-19 crisis. At the beginning of this outbreak, the New York Times published, “The Workers Who Face the Greatest Coronavirus Risk.” Dentists and dental hygienists were at the far-right corner of the graph were depicting that those in the profession have the most frequent exposure to COVID-19 and the closest proximity to others during their workdays. As dental settings have unique challenges that require specific infection control strategies, CDC published “Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response” to resume non-emergency dental care, which was on hold during the initial outbreak of COVID-19 by state order. It recommends balancing the need to provide necessary services while minimizing risk to patients and dental health care personnel.

Mount Sinai dental clinics have been serving patients with emergency dental cases during the pandemic, and we are in the process of providing routine dental care.

Although we face many challenges, this can be a time of opportunity as well. Dentistry has centered on a “drill-fill-bill” model, where definitive treatments are incentivized. However, as dentists work to minimize aerosol exposure while preventing oral health diseases, dental procedures that focus on disease management and prevention are on the spot. These procedures include silver diamine fluoride application to arrest dental caries and indirect pulp cap with Hall technique crowns—which may not require high-speed dental drills. There are also many efforts within the Mount Sinai Health System to integrate oral health into its existing primary care and prenatal care strategies.

Since 2019, the CenteringPregnancy programs at The Mount Sinai Hospital and the Mount Sinai Adolescent Health Center have embraced an interactive oral health education model where pregnant women are connected to Mount Sinai dental facilities if they do not have a dental provider. Mount Sinai OBGYN providers, pediatricians, and prenatal care nurses plan to integrate oral health education and care navigation into their existing care models. While we continue to provide our patients with excellent, up-to-date dental care, we are committed to focusing on these upstream approaches where the new norm for children’s oral health becomes no caries. Furthermore, this new norm will include the systems of care that value health as well as health care.

Hyewon Lee, DMD, MPH is a former U.S. Public Health Service officer at the Department of Health and Human Services, a member of the Blavatnik Family Women’s Health Research Institute and an Assistant Clinical Professor at the Department of Dentistry at The Mount Sinai Hospital. Her goal is to integrate oral health into primary and prenatal care to advance the oral health of mothers and young children.

We Can Learn From This Crisis: Reflections on COVID-19 and Health Disparities

Kimberly Glazer, PhD, MPH

The COVID-19 pandemic is a watershed global health crisis. It is heartrending, uncharted territory. Here in New York City, we have weathered a health emergency nearly inconceivable just a few months ago. With incredible fortitude, compassion, and grace, health care professionals and other essential workers carried us past the crest of this wave of infection. We have been forced to learn a set of arduous lessons: about the price of foregone planning and prevention; about limitations in our capacity to control hazards in an interconnected world; and about the imperative of working together to develop and share solutions to existential global issues.

In reflecting on the challenges of the past weeks, I cannot help but connect this crisis with my own research area of perinatal health. I have spent my postdoctoral training learning from expert clinicians, epidemiologists, and health service researchers studying maternal and infant health disparities in New York City. The themes coming to the surface in this pandemic, in particular its disproportionate toll on communities of color, are regrettably familiar.

COVID-19 mortality data indicate a clear differential impact by race. In a previous post, we showed how Black, poor neighborhoods suffer the highest burden of COVID-19 in New York City. According to the COVID Racial Data Tracker, a collaboration between The Atlantic’s COVID Tracking Project and the Antiracist Research and Policy Center, Black people are dying at a rate nearly two times higher than their share of the population. Some data suggest that Black people may be less likely to receive coronavirus testing when symptomatic, and delays in diagnosis and treatment are particularly consequential for people of color, who are more likely to suffer from risk factors for severe illness such as diabetes and hypertension. In another report, “The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S”, researchers at APM Research Labs conclude: “if they had died of COVID-19 at the same rate as White Americans, about 13,000 Black Americans, 1,300 Latino Americans and 300 Asian Americans would still be alive.”

We confront similarly appalling disparities for perinatal outcomes. The U.S. maternal mortality rate increased while other nations halted or reversed their trends. Black mothers die at alarmingly high and disproportionate rates, their infants are less than half as likely as their non-Hispanic White counterparts to survive the first month of life, and both Black and Latina mothers face increased risk of life-threatening pregnancy-related complications. A large proportion of these disparities are due to preventable complications and systematic deficiencies in obstetric and neonatal care quality.

Our research team at the Blavatnik Family Women’s Health Research Institute has developed a body of research examining these inequities. Critically, there is a growing recognition of disparities that persist even beyond differences in underlying health conditions, insurance coverage, and the hospitals where women receive care. Entrenched racial and ethnic biases manifest in power imbalances and communication gaps in maternal and neonatal care, contributing to the unnecessary escalation of avoidable morbidity.

I read an article about the impact of COVID-19 on global hunger, in which a volunteer in Kibera, the largest Nairobi slum, called the coronavirus “the great revealer, pulling the curtain back on the class divide and exposing how deeply unequal this country is.” His quote referred to Kenya but could have easily described the trajectory of the pandemic, or any number of health issues, here in the United States. In this moment, as we confront the legacy of deep-seated, structural racism and bias in our country, it is past time to challenge the systems that create the conditions for disparities.

This emergency provides a trying but important lesson in empathy–of shifting our paradigms to consider, and prioritize, equity and the common good. Looking out my window over the past few weeks–at largely empty streets, peppered with socially-distanced dog walkers and stir crazy runners–I have been heartened to see people heeding the warnings of public health and medical officials. Extreme social isolation has been necessary to slow the pace of infection and conserve health resources for those who need them most. We are living out the tension between individual liberty and public safety: taking stock of the implications that our choices have, day in and day out, for those around us, and considering the experiences of those whose circumstances differ from our own.

This is public health. And (though of course I am biased), I also think it is the best of humanity. When we force ourselves to ask difficult questions about what we can live without, what we need to mobilize now to mitigate future harm, and how to redress inequitable risk. These questions are applicable to a viral pandemic, a maternal mortality crisis, and each of the seemingly mounting threats facing humanity. Now what do we do with this wake-up call?

We can learn from this crisis. We can change how we think about health, and the capacity of our infrastructure, systems, and workforce to protect it. Listen to the data, engage the experts, and proceed as if lives depend on our actions. They always do.

Kimberly Glazer, PhD, MPH, is a perinatal epidemiologist with research interests in obstetric management and peripartum morbidity, with specific attention to maternal obesity. She is a postdoctoral fellow with the Blavatnik Family Women’s Health Research Institute. Her research evaluates social and quality of care determinants of severe maternal morbidity, adverse neonatal outcomes, and racial/ethnic perinatal disparities.

LGBTQ+ Health with Zoe Rodriguez, MD

Those who identify as LGBTQ+ often have different health care and treatment needs. Clinicians must be trained to better understand and respond to those needs, according to Zoe Rodriguez, MD, a Blavatnik Family Women’s Health Research Institute faculty member and an Assistant Professor in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai and Vice Chair of Operations at Mount Sinai’s Downtown campus.

Dr. Rodriguez discusses LGBTQ+ health in this Q&A made in recognition of LGBTQ+ Pride Month.

The Icahn School of Medicine at Mount Sinai has instituted curriculum changes to include diverse perspectives in health care for our medical students to build that knowledge base. Unfortunately, disparities exist in the LGBTQ+ community in health care due to years of discrimination and access to health, including sexual and mental health.  Dr. Rodriguez shares some of the resources that are available to patients who identify as LGBTQ+ in New York City.

Dr. Rodriguez is also part of the Center for Transgender Medicine and Surgery at Mount Sinai that provides gender-affirming surgeries, as well as comprehensive primary and mental health care for transgender people.

One of her patients wrote the following about their experience with her: “Dr. Rodriguez is THE OB-GYN for trans folk in NYC. Her and her staff are clearly in the loop and are consistently understanding and respectful. I would recommend every time for guys looking for that particular operation.”

Another wrote, “As a trans man I left so happy that I went. I was so nervous and kept canceling right before my appointment. Finally, I went and I was so relieved. They were EXTREMELY nice and respectful. Used all the correct pronouns and were helpful with any questions I had about my current transition. I would highly recommend Dr. Rodriguez and her amazing nurse to anyone.”

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