<p>The Need for Transgender Healthcare Medical Education in a Developing Country</p>

Abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/NggAFXxX9vwPurpose: The single most significant barrier to healthcare for people who identify as transgender is poor access to healthcare providers trained in trans-health. Despite this, transhealth education is far from being a routine component of the undergraduate medical curriculum in developing countries like Pakistan. This study aimed to assess knowledge and attitudes regarding people who identify as transgender, as well as the perceived need for trans-health in the curriculum, amongst medical students in Pakistan.Materials and Methods: A cross-sectional study using a self-designed questionnaire was carried out amongst undergraduate medical students at the Aga Khan University. Stratified random sampling was used, whereby students were stratified based on their current year of medical education.Results: A total of 249 students were included in this survey. The majority (61%) had poor overall knowledge, with a significantly higher percentage of pre-clinical students (79.6%) having poor knowledge regarding differences in transgender health needs compared to clinical students (60.3%; p = 0.001). Most students acknowledged that individuals who identified as transgender faced a lack of access to healthcare (78.3%), were poorly integrated into society (92.0%) and were treated differently in a clinical setting (58.6%). Many students were unsure of how to address (49.8%) and clinically examine (38.2%) patients identifying as transgender. However, most students demonstrated good (49.4%) or fair (45.0%) attitudes towards individuals who identified as transgender, and the majority reported a high (54.6%) or moderate (42.2%) perceived need for the inclusion of trans-health in the medical curriculum. Conclusion:Despite deficiencies in trans-health education in the medical school curriculum, positive attitudes and a high perceived need among students lay the foundation for developing a medical curriculum that gives due priority to trans-health. In developing countries, this can help bridge disparities in healthcare provision to people who identify as transgender.

Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

“…While this finding may be somewhat unsurprising given the lack of transgender-specific training provided through medical education in Australia [78][79][80][81], it is troubling given that general practice clinics were by far the most commonly attended sites for sexual health care in our sample. Although eliminating cisgenderism and transphobia in all health settings is essential, we echo conclusions from other research that general practitioners must be a priority in terms of transpositive professional development [6,82,83].…”

Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective

“…The lack of respect and support leads to transsexual persons being endangered to permanently suffer from distressing situations affecting their intimate life. It has been pointed out that the lack of access to healthcare providers that are sufficiently trained with respect to the specific needs of transsexual individuals is the single most barrier regarding access to healthcare for transsexual persons [ 7 ]. An abolishment of legal uncertainties and a reliable provision of reimbursement for trans-specific care seems to be a significant precondition for healthcare providers to engage in trans care and for medical education institutions to incorporate trans-specific knowledge in their curricula.…”

“…Although there has been considerable progress regarding the acceptance and protection of gay, lesbian, bisexual, transgender, and non-binary gender individuals (hereinafter ‘individuals of sexual and gender minority’, SGM), they still suffer from substantial discrimination and disparities regarding their access to healthcare [ 1 , 2 ], especially in the case of transsexual persons and their access to transition-related care [ 3 ]. SGM individuals also report experiences of discrimination by healthcare providers [ 4 , 5 ], who often lack specific and adequate training concerning the needs of SGM individuals [ 6 , 7 , 8 ]. Although higher levels of knowledge regarding SGM individuals have been found to be correlated with more positive attitudes towards SGM persons [ 9 ], individual cases of discrimination in healthcare can be based on healthcare professionals’ moral convictions and attitudes.…”

An undergraduate medical curriculum framework for providing care to transgender and gender diverse patients: A&nbsp;modified Delphi study

“…We also acknowledge the complex interplay between the needs and challenges of TGD and people with Disorders of Sexual Differentiation, which do not always align. Although the need for TGD training in medical education in developing countries has been established [ 33 ], our focus on a single country may limit the generalizability of our findings to other jurisdictions. We expand on this in the following section.…”