When Justin Hooks went to his primary care provider, he expected to be able to ask for preventative medicine against HIV. As a young gay man, he had seen friends diagnosed with HIV and wanted to take the extra precaution to ensure he remained healthy.
But he did not get the care he was looking for from his Michigan-based provider.
“I was denied by a nurse practitioner and told to go to Planned Parenthood. They didn’t feel comfortable dealing with ‘someone like me,” Hooks said. “So, I had to find a new doctor — one who knew how to take care of people like me.”
That experience led Hooks to change careers, from flight paramedic to nurse practitioner. Now, as a post-master’s Doctor of Nursing Practice student at the Michigan State University's College of Nursing, Hooks is on a mission to educate health care providers about the importance of gender-affirming care.
In his recent article, “Primary Care and Transgender and Gender-Diverse Patients,” in the American Academy of HIV Medicine’s HIV Specialist magazine, Hooks advocates for “judgment-free care” and notes that many providers lack of knowledge on sexual health and often reveal implicit biases during patient interactions.
When seeing patients, Hooks always begins by expressing gratitude for their trust in sharing their stories. Many seek him out at the People’s Clinic for Better Health in Port Huron because they know they will receive the compassionate, judgment-free care they deserve. The clinic provides essential services, including preventive care, routine health screenings, women’s health, diabetes education and benefits counseling. It also serves as a preceptor location for the college.
“I’m just thankful for patients who have been historically discriminated against for a long time that show up to take the first step in creating a healthier self,” Hooks said. “I try to create an environment so they can be themselves. There should be no difference in taking care of someone identifying as an LGBTQ person than anyone else.”
Some missteps, Hooks notes, are when providers feel they need to do a complete anatomical inventory for a routine sick visit.
“For example, if you have a transman with lower abdominal pain, it is important to know whether they have in intact uterus, ovaries and cervix so you know where the pain is originating and how to treat it,” he writes. “Knowing whether the patient had top surgery to remove breast tissue would not be pertinent in the care of this transman.”
Avoiding misgendering and using appropriate pronouns are two other areas where providers can improve their relationship with patients. Hormone therapy is another opportunity for improvement with providers, he writes.
“Some primary care providers can be hesitant to initiate or manage hormone therapy because they do not feel they have enough experience caring for transgender or gender-diverse individuals. I remind them to focus on the medicine, not the person’s gender expression.”
Hooks is currently speaking to classes and at events, as well as consulting other organizations about the best practices for transgender and gender-diverse patients — all while completing the final year of his Doctor of Nursing Practice program at MSU.
A Metro Detroit native, Hooks earned his Master of Science in Nursing from Simmons University in Boston, where he had an opportunity to train in LGBTQIA+ health care through the Fenway Institute and gain clinical experience at some of the nation’s most respected hospitals, including Brigham and Women’s, Beth Israel Deaconess, Massachusetts General and VA Boston Healthcare. This foundation shaped his dedication to delivering affirming, patient-centered care.
After relocating to Michigan, Hooks got involved with the Michigan Council of Nurse Practitioners, where he met many Spartan Nurses. His brother, a physician, did his residency and fellowship at MSU — which made coming to East Lansing a “no-brainer.”
In his DNP works, Hooks aims to expand upon this master’s thesis, which focused on confidence versus competence in nurses’ ability to take care of the LGBTQ population alongside his advisor, Nurse Anesthesiology Program Director Gayle Lourens. In his findings, he learned that many nurses are first exposed to these skills not until they take a continuing education course. Ultimately, he said, those skills and conversations need to start happening in school.
“There is a need for people to have readily accessible education,” he said, adding he is in discussion with the college’s Office of Continuing Education and Professional Development to develop some offerings. "Having the support of not only MSU but the faculty and staff gives me a true sense of belonging and for that I'm grateful.”
