Health Care Providers' Comfort With and Barriers to Care of Transgender Youth

Vance, Stanley R.; Halpern‐Felsher, Bonnie; Rosenthal, Stephen M.

doi:10.1016/j.jadohealth.2014.11.002

Cited by 161 publications

(121 citation statements)

References 7 publications

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“…Our results dovetail with existing research findings that highlight ongoing barriers to providing quality transgender-specific care in VA and non-VA settings [25][26][27][28]. Although continually revised standards of care for transgender patients have been available through the World Professional Association for Transgender Health (WPATH) for over 2 decades [29], the majority of health care professionals do not receive training in transgender health [1].…”

Section: Discussionsupporting

confidence: 72%

Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

Blosnich¹,

Rodriguez²,

Hruska³

et al. 2018

Preprint

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communication-related problems with e-consult, impractical recommendations for underresourced sites, and misunderstanding e-consult purpose. Improvement suggestions included adding concise/sectioned responses, expanding provider/patient program awareness, designating a follow-up contact person, and increasing provider education about transgender Veterans and related care. Quantitative analysis found common reasons for not using the program were: not knowing about it, not needing to use it yet, and getting help from a colleague outside of econsult. Common suggestions to improve program use were: more information about where to find e-consult in the chart, guidance on talking with patients about the program, and e-mail announcements to improve provider awareness of the program. Post hoc exploratory analyses showed no differences between urban and rural providers. Conclusions:The VA transgender e-consult program is useful to providers, but there are several barriers to implementing recommendations, some of which are especially challenging for rural providers. Addressing noted barriers and enhancing the facilitators may improve program use and improve quality care for transgender Veterans.

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Section: Discussionsupporting

confidence: 72%

Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

Blosnich¹,

Rodriguez²,

Hruska³

et al. 2018

Preprint

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“…The consistency of the results from the 2 survey tools created by reputable organizations, the AAMC and Vanderbilt, provides solid evidence that GUSOM did not adequately prepare its students to meet the health needs of their future LGBTQI patients. The results echoed the results of similar studies, which found gaps in the care of transgender patients [4,5]. It indicated that additional learning objectives and educational content must be added to the preclinical curriculum to better prepare students to care for LGBTQI patients.…”

Section: Audit Results At Georgetownsupporting

confidence: 64%

“…A survey of 170 medical schools and 4,262 students found that most students view their school’s LGBT-curriculum as ‘fair’ or worse, with the largest gaps in gender transitioning and sex reassignment surgery [3]. Other studies echoed the sentiment that transgender care is the most lacking portion of LGBTQI healthcare in medical education [4,5]. Such a gap in medical school training has left some physicians ill equipped to meet the needs of their LGBTQI patients.…”

Section: Problemmentioning

confidence: 99%

Queering medical education: systematically assessing LGBTQI health competency and implementing reform

DeVita

Bishop

Plankey

2018

Medical Education Online

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Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals face well-established health disparities. American medical schools have been inconsistent in their training in the care of LGBTQI-identified patient, and many have not formally assessed their curriculums for content related to the care of LGBTQI-identified patients. From 2015 to 2016, the authors systematically evaluated Georgetown University School of Medicine’s preclinical curriculum for its LGBTQI competency using video lecture capture, LGBTQI health competencies published by the American Association of Medical Colleges (AAMC) and learning objectives developed by Vanderbilt University. Based on the results of the curricular audit, the authors have created didactic content targeted at the identified curricular gaps that has been implemented throughout the preclinical curriculum at Georgetown. The curricular auditing process described here could be replicated at other medical schools, which would allow educators to develop targeted content to address unmet competencies. Abbreviations AAMC: Association of American Medical Colleges; LGBTQI: Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex

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“…Prior publications demonstrate a similar pattern beyond the undergraduate level. Among adolescent health care providers, only 47.1% felt confident providing adequate medical therapy to transgender youth, with 65.1% indicating that lack of training as a major barrier [34, 35]. Identifying these gaps by healthcare providers is the first step in improving the curriculum.…”

Section: Discussionmentioning

confidence: 99%

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Nama

MacPherson

Sampson

et al. 2017

Medical Education Online

102

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Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

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Health Care Providers' Comfort With and Barriers to Care of Transgender Youth

Cited by 161 publications

References 7 publications

Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

Queering medical education: systematically assessing LGBTQI health competency and implementing reform

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

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