“Pediatric and Adolescent Gynecology: The Few and the Proud” – with Dr. Gylynthia Trotman

In this episode, Dr. Gylynthia Trotman discusses Pediatric and Adolescent Gynecology, including her path to being educated in the subspecialty and what an average appointment with her patients is like. Dr. Fox also interviews her about her background, including growing up spending summers in the Caribbean and how that influenced her career. Dr. Trotman is an assistant professor of Obstetrics, Gynecology, and Reproductive Science as well as Pediatrics at Mount Sinai in New York City.

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Dr. Gylynthia Trotman was born in Brooklyn, and spent most of her summers growing up in the Caribbean with her family. While there, she learned about many tragedies in women’s health, and at fourteen, this drove her to pursue a dream of practicing Obstetrics and Gynecology. She attended medical school at SUNY Downstate and later completed her residency at Mount Sinai, where she met Healthful Woman host Dr. Fox.  

Despite her long-held dream of pursuing OBGYN, Dr. Trotman experienced a “culture shock” during her rotation in the practice and describes finding that most people she encountered in OBGYN didn’t seem happy. However, she found later that the work was fulfilling, and even though some experiences were stressful or difficult, this made her happy overall. She also later found that she “really loved the adolescent population” and wanted to take care of these patients because she was often reminded of herself or her friends growing up and wanted to offer guidance. She also enjoyed seeing their disposition change as she helped adolescent patients overcome their worries related to their gynecological care, and found these experiences motivating.  

Dr. Trotman then learned about the North American Society of Pediatric and Adolescent Gynecology after doing some research into potential subspecialties. Pediatric and Adolescent Gynecology (PAG) is a relatively rare subspecialty; at the time of her graduation, Dr. Trotman was one of only four fellows in PAG. She describes the fellowship training as “literally learning medicine all over again,” because the subspecialty is so different from general gynecology. She adds that there is a push to increase the number of PAG specialists by creating certifications for the subspecialty, with a goal of having at least one Pediatric and Adolescent Gynecologist at every children’s hospital.  

As a Pediatric and Adolescent Gynecologist, Dr. Trotman says she sees patients who are up to 23-25 years old, and often patients come to her because they have problems with their period, pelvic pain, or vulva/vaginal problems like persistent itching or burning. Her regular work includes anything from reproductive health counseling for 13-14 year old patients to overseeing care for more complex cases such as abnormal or incomplete development. Because gynecology for pediatric and adolescent patients is so complex, Dr. Trotman notes that she often must coordinate with doctors in other specialties or subspecialties.  

Dr. Trotman explains that before puberty, surgery or other interventions aren’t commonly necessary, so much of her job is concerned with counseling and explaining care for patients and parents. She says that although “maybe 10% of parents want to keep [the diagnosis] from their children,” informing kids about their bodies when they’re young allows them to feel more empowered and confident as they grow up.  

Building relationships with her patients is also crucial for Dr. Trotman. She explains that this is achieved by going to patients first before parents, and that she takes other steps like tending to “dress down” and not wearing a white coat to seem more approachable. She takes care to gauge what’s important for the patient and avoiding performing an examination until the patient is comfortable. She also explains that it’s important to have confidential meetings with all patients who are about 12 and older to build a relationship and trust