Frances W. Grimstad, MD, MS, has been named a 2023 Castle Connolly Top LGBTQ+ Doctor and Castle Connolly Rising Star.
Dr. Grimstad is a pediatric and adolescent gynecologist with Boston Children’s Hospital. Her patients range in age from newborn to about 35 years old, but she focuses on care — both medically and surgically — for a range of gynecologic conditions and concerns that can affect the sexual and/or reproductive health of pediatric/adolescent patients.
Conditions she treats include menstrual irregularities, endometriosis, ovarian cysts, vulvitis, vaginal agenesis, and congenital differences in the uterus, labia, hymen, and other organs and structures.
A lesbian who has been “out” since she was in middle school, Dr. Grimstad has special interest and expertise in providing gender-affirming care LGBTQ+ care, including surgery. This includes the medical and reproductive health of people who are transgender, have differences in sex development (DSDs); and/or suffer from gender dysphoria.
Because her team cares for patients of various ages and sexual orientations, “patient experiences are very individualized,” she says. “We gear everything around ensuring that we meet every patient where they are and address their needs in a trauma-informed, holistic way.”
The founder of the Transgender Reproductive Health Service at Boston Children’s, Dr. Grimstad serves as a gynecologist in the Center for Gender Surgery and the Being-U Clinic, which serves people with differences in sexual development.
She is also an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.
Dr. Grimstad is certified by the American Board of Obstetrics and Gynecology, with subspecialty certification in pediatric and adolescent gynecology.
Alex Sheldon, GLMA's Executive Director, and Castle Connolly’s Managing Director Steve Leibforth recently presented Dr. Grimstad with a commemorative plaque.
“Being recognized as a Castle Connolly Rising Star means I’m part of a group of clinicians who are changing what the face of medicine looks like and who are working to improve lives in the communities we serve and belong to,” Dr. Grimstad says.
“And being named to the first Castle Connolly LGBTQ+ Top Doctors list is also such an honor, especially because the list is co-presented by GLMA, an organization I’ve valued for years. The list is special because it recognizes that visibility of LGBTQ+ individuals is important — both in advocacy spaces and in health care, especially in times of adversity toward sexual- and gender-minority communities.”
Castle Connolly is presenting its first Top LGBTQ+ Doctors list in partnership with GLMA: Health Professionals Advancing LGBTQ+ Equality — formerly called the Gay and Lesbian Medical Association — the oldest and largest organization of LGBTQ+ healthcare professionals.
“I went into health care to provide gender-affirming care”
Dr. Grimstad pursued a career in medicine to serve the LGBTQ+ community.
“I initially decided to become a clinician as a high-school student working in LGBTQ+ advocacy, where I saw that my trans-identified peers had far greater deficits and access to health care than I did as a lesbian, and I realized that was an area where I could make a difference,” she says. “So I went into health care to provide gender-affirming care.”
She chose her subspecialty so she can impact and care for developing young people as they make choices about themselves and their bodies.
“I decided to focus on pediatric and adolescent gynecology because a lot of decisions surrounding sexual and reproductive health — including in the trans and intersex communities — are made when people are young,” says Dr. Grimstad. “And I wanted to be a part of the teams and systems created to ensure that we help all patients live their fullest lives in terms of their sexual and reproductive health.”
Dr. Grimstad believes that being gay helps her better empathize with and serve LGBTQ+ patients.
“As a lesbian-identified physician, I share with and can understand certain experiences with those patients, including being invisible as a patient. And although many LGBTQ+ communities experience far greater disparities in access to care than I have as a gay white woman, I understand what it means to be part of a healthcare system that is not designed for me,” she says.
“So I try to listen and learn from my peers about their experiences and focus on those as I help to work toward a better future,” she says.
“It’s going to get better for the next generation of LGBTQ+ physicians. It was hard decades ago for the people who paved the way for my generation — when many people were in the closet and faced outright discrimination and risks to their employment and access to care — and hard for our generation at the start,” says Dr. Grimstad.
“It’s been hard because the work is worth it. The outcomes are worth it, our LGBTQ+ patients are worth it, and the better world we’re helping to build is absolutely worth it.”
Dr. Grimstad considers herself privileged to have had lifelong acceptance and support from those around her.
“I’ve been fortunate to have what I think every LGBTQ+ person should have: a strong, supportive, empowering foundation of family and peers,” she says. “They’ve been there in times of adversity and helped me feel like I’ve never needed to back down or hide who I am.”
Suggestions for improving medicine for LGBTQ+ patients and clinicians
Dr. Grimstad believes there are three steps the medical community overall can take to foster a more inclusive and affirming environment for LGBTQ+ health professionals and patients.
The first is to ensure visibility, she says. “We need to be aware of who is LGBTQ+ and recognize and honor these individuals within both employee systems and patient communities. People need to be counted.”
Her second suggestion is for members of the medical community to “recognize that gender identity, sexual orientation, anatomy, and the ways we use our anatomies in sexual activity are unique and diverse. These are not binary topics, and we need to build a medical education system that reflects and includes that diversity,” says Dr. Grimstad.
“Medicine is not accurate when it tries to prescribe a binary approach to the ways in which we practice medical care. This is one reason I believe my team’s work to restructure how we think about medicine — to think beyond the binary and create a more accurate clinical system — is so critical.”
Dr. Grimstad’s third suggestion is simple but important: people must vote to bring about larger change.
“Voting is so important,” she says. “We need to vote to ensure that the government-based institutions that influence the policies and procedures that impact LGBTQ+ patients and clinical spaces are inclusive and protective, and that they recognize the amazing diversity of LGBTQ+ people.”
GLMA advocacy is improving care for people with differences in sex development
Dr. Grimstad is happy to be involved in an organization she believes is doing valuable work to improve health care for LGBTQ+ people, particularly one little-understood population.
“GLMA has been exceptionally impactful in my career, and it's been an honor to work alongside a diverse group of leaders to advance equality in many different healthcare domains,” Dr. Grimstad says.
“In addition to my focus on gynecology and gender-affirming care, we think collectively about the LGBTQ+ community overall, the ways in which the community interfaces with the healthcare system, and how we can advocate for equity at every step and level of that.”
A key reason Dr. Grimstad got involved in GLMA, she says, was to increase the visibility of people with differences in sex development (DSD), such as those with intersex traits.
“It’s important to recognize that there are people born with variations in their sex characteristics that don't fit into the male-female binary that typically comes to mind when we think of bodies,” she says. “And those individuals also deserve culturally competent, medically accurate health care.”
Dr. Grimstad says that advocacy through GLMA has started to improve the care of these populations.
“Since I joined GLMA a couple of years ago, differences in sex development have become a central piece of our annual conferences,” she says. “We now have many education materials geared towards educating clinicians on the fact that sex is not binary and actually holds a great deal of diversity, similar to gender and sexual orientation.”
About Castle Connolly
Top Doctors are nominated by peer physicians and selected by the physician-led Castle Connolly research team. Physicians cannot and do not pay to be selected.
Castle Connolly publishes its Top Doctors list at castleconnolly.com and in a number of print and online partner publications. Nominations are open to all board-certified MDs and DOs. The Castle Connolly team chooses honorees based on nominee criteria that includes their medical education, training, hospital appointments, and disciplinary histories.
If you’re a physician— someone with a long-standing commitment to delivering the highest-quality patient care — learn how to nominate a Top Doctor.
