Australian endocrinologists need more training in transgender health: A national survey

Abstract

Objective An increasing number of trans and gender diverse (TGD) individuals are seeking gender‐affirming hormone therapy for gender transition. Little is known about the levels of training, experience and confidence of endocrinologists in providing care and lack of training and experience is a potential barrier to individuals seeking appropriate and timely health care. We aimed to assess the level of training and confidence of Australian endocrinologists and trainees in the endocrine management of trans and gender diverse individuals in a representative sample. Design Endocrinologist and trainee members of the Endocrine Society of Australia were invited to participate in an anonymous 14‐item survey. Of the 545 members, 147 clinicians (95 adult endocrinologists, 2 paediatric endocrinologists and 50 endocrinology trainees) responded. Results When presented with a scenario regarding commencement of gender‐affirming hormone therapy, only 19% felt confident providing clinical care to TGD individuals. Compared to other areas of endocrinology, 75% felt less or not at all confident in commencing hormone therapy in a TGD patient. No training in transgender medicine during medical school or during their endocrinology training was reported by 96% and 60%, respectively. There were significantly higher levels of confidence in all aspects including performing a consultation in those who had previously seen a TGD patient. The desire for more training was high (91%). Conclusions These results highlight the shortfall in training in TGD health care amongst endocrinologists and show that prior clinical experience is associated with higher levels of confidence. Medical schools and endocrinology fellowship training programmes will need to adapt to meet the increasing demand for quality TGD health services.

Trans health training objectives: A scoping review

“…similarly high rate of exclusion is seen in existing scoping reviews, 1,44 and although we could not locate any international scoping reviews on the topic, a similar paucity of transgender health training is reflected in the primary literature worldwide. 1,[13][14][15][16] Future studies utilising a modified-Delphi method 50 This…”

“…1,[13][14][15][16] This paucity of transgenderspecific curricula in undergraduate and postgraduate training programmes has perpetuated physician inexperience and discomfort with the provision of care to transgender populations, leading to transgender patients being denied care, avoiding health care environments when they need care, and experiencing the added burden of needing to advocate for themselves to receive equitable care. [13][14][15]17 In a recently published Trans PULSE Canada survey of transgender Canadians, over 45% had one or more unmet health needs in the past year. 7 Transgender health gaps are perpetuated and even widened by the health care system.…”

Transgender Healthcare and Medical Education: An Inductive Thematic Analysis of Digital Discourse

“…Respondents also reported that only 4% received training on TGD care in medical school. However, 91% indicated a desire for additional training [20].…”

Need for Inclusive Consideration of Transgender and Gender Diverse People in E-Health Services: A Systematic Review

“…At the same time, implementing TGD-related training curricula, supervision, and consultations for HCPs online could advance professionalization in trans health care and further reduce barriers resulting from stigma [14][15][16]. The need to train HCPs extends to all health care disciplines, from primary care to nursing, whose practice-based training curricula should enable them to work from a TGD-informed standpoint [17][18][19][20].…”