Transgender health care: improving medical students' and residents' training and awareness

Abstract

BackgroundA growing body of research continues to elucidate health inequities experienced by transgender individuals and further underscores the need for medical providers to be appropriately trained to deliver care to this population. Medical education in transgender health can empower physicians to identify and change the systemic barriers to care that cause transgender health inequities as well as improve knowledge about transgender-specific care.MethodsWe conducted structured searches of five databases to identify literature related to medical education and transgender health. Of the 1272 papers reviewed, 119 papers were deemed relevant to predefined criteria, medical education, and transgender health topics. Citation tracking was conducted on the 119 papers using Scopus to identify an additional 12 relevant citations (a total of 131 papers). Searches were completed on October 15, 2017 and updated on December 11, 2017.ResultsTransgender health has yet to gain widespread curricular exposure, but efforts toward incorporating transgender health into both undergraduate and graduate medical educations are nascent. There is no consensus on the exact educational interventions that should be used to address transgender health. Barriers to increased transgender health exposure include limited curricular time, lack of topic-specific competency among faculty, and underwhelming institutional support. All published interventions proved effective in improving attitudes, knowledge, and/or skills necessary to achieve clinical competency with transgender patients.ConclusionTransgender populations experience health inequities in part due to the exclusion of transgender-specific health needs from medical school and residency curricula. Currently, transgender medical education is largely composed of one-time attitude and awareness-based interventions that show significant short-term improvements but suffer methodologically. Consensus in the existing literature supports educational efforts to shift toward pedagogical interventions that are longitudinally integrated and clinical skills based, and we include a series of recommendations to affirm and guide such an undertaking.

Transphobia rather than education predicts provider knowledge of transgender health care

“…The TGD Healthcare Knowledge Scale (Appendix ) was constructed for this study, in consultation with experts in the field and based on training assessment questionnaires . The 12‐item scale explored knowledge in three domains relevant to core competencies in primary care for TGD individuals . Four questions assessed social aspects of TGD health care (e.g.…”

“…27,28 The 12-item scale explored knowledge in three domains relevant to core competencies in primary care for TGD individuals. 29 Four questions assessed social aspects of TGD health care (e.g. pronoun use and social determinants of health), as understanding those aspects has been deemed essential to culturally appropriate interaction with TGD patients; two questions evaluated preventive care (breast cancer screening and mental health) of TGD people; and six questions evaluated knowledge regarding transition-related care, including hormone prescription and criteria for surgery, based on widely used published guidelines.…”

Prevalence and curriculum of sexual and gender minority education in Japanese medical school and future direction

“…unique health issues and health needs. More specifically, education providing knowledge of unique clinical concerns and social considerations facing transgender patients, as well as building needed clinical skills, is essential to delivering compassionate, competent care [44]. A transgender patient's health concerns should not be aggregated into LGB health issues [44].…”

Transgender health and its current omission from medical school curriculum: medical students’ perspective

“…We thank the authors for their correspondence to our article 1. They raised a well-taken point that the lack of transgender health education is not limited to the USA and Canada, which encompassed the geographic scope of our review.…”