Transgender-Related Education in Plastic Surgery and Urology Residency Programs

Morrison, Shane D.; Dy, Geolani W.; Chong, H. Jonathan; Holt, Sarah K.; Vedder, Nicholas B.; Sorensen, Mathew D.; Joyner, Byron D.; Friedrich, Jeffrey B.

doi:10.4300/jgme-d-16-00417.1

Cited by 83 publications

(57 citation statements)

References 12 publications

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“…In a study of undergraduate medical education in the USA and Canada in 2009-2010, only 30.3% of the 150 medical schools surveyed reported teaching about gender transitioning [77]. Gaps in residency programs in the USA have been described for Emergency Medicine [78], Urology [79] and Plastic surgery [80]. A survey of 15 Australian and New Zealand medical schools found that teaching about gender and gender identity is varied across schools, with seven respondents (47%) unsure about what is taught [81].…”

Section: What Are the Gaps In Curricula?mentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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Background: Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. Main body: Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to genderaffirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. Conclusion: There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

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Section: What Are the Gaps In Curricula?mentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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“…In a survey of emergency medicine residency program directors, Moll et al 20 found that most programs did not contain lesbian, gay, bisexual, and transgender (LGBT)-specific curricular content. Related studies looking at undergraduate medical training, 21 various residency programs, [22][23][24][25] and public health schools 8 describe similar results. Lack of healthcare provider education is an identified barrier to accessing equitable healthcare for members of the SGM communities, 11,[26][27][28][29] highlighting the need for more research and formalized inclusion within medical training.…”

Section: Résumémentioning

confidence: 72%

“…Few studies have assessed the presence of SGM education within medical and healthcare provider curricula, so no validated surveys are available. 8,9,[20][21][22][23][24][25] Components of the literature, specifically an article by Burns et al, 38 aided the design and creation of a 32-item questionnaire (eAppendix, available as Electronic Supplementary Material), composed of both open and closed questions. Using an iterative process, a total of 12 individuals consisting of healthcare providers and SGM-identified people from within our local network of colleagues, researchers, and community members provided feedback to develop and refine the survey instrument.…”

Section: Instrument Developmentmentioning

confidence: 99%

Sexual and gender minorities educational content within obstetric anesthesia fellowship programs: a survey

MacCormick

George

2020

Can J Anesth/J Can Anesth

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“…Education on the care of sexual and gender minority patients has been found to be lacking not only in medical education and medical residency programs, but in predoctoral dental education. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] For this reason, many providers may be uncomfortable with the delivery of care to transgender people.…”

mentioning

confidence: 99%

U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender‐Affirmation Education: A National Survey

Ludwig

Dodson

Morrison

2019

Journal of Dental Education

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With a growing number of individuals seeking gender‐affirming surgery, there is a greater need for providers, including oral and maxillofacial surgeons, experienced in the surgical care of transgender people. The aim of this study was to evaluate oral and maxillofacial surgery (OMS) residents’ exposure to the care of transgender people and their perceived importance of education in gender‐affirming surgery. All 1,174 OMS residents in accredited U.S. training programs were invited to participate in this cross‐sectional study between July 1, 2017, and January 30, 2018. The predictor variables were residents’ gender, program region, program type, and level of training. The outcome variables were frequency of exposure to the care of transgender people, aspects of care covered, perceived importance of such training, and perceived need for fellowship opportunities in gender‐affirming surgery. Results were analyzed for 87 respondents, for a 7.4% response rate. Among the respondents, 81.6% were male; 64.4% were training in combined MD degree‐OMS certificate programs; and 31% reported having had exposure to the care of transgender people during their residency. On a scale from 1=neutral to 3=very important, the respondents’ mean reported importance of receiving training in gender‐affirming surgery was 1.37±0.94. Also, 37.9% reported that fellowship training should be offered in gender‐affirming surgery, specifically facial feminization/masculinization. These results showed that the OMS residents had had limited exposure to the care of transgender people, but they perceived that such exposure should be an important component of their training. Further research is needed to collect results from a larger sample and to better understand the role of oral and maxillofacial surgeons in gender‐affirmation surgery.

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Transgender-Related Education in Plastic Surgery and Urology Residency Programs

Abstract: Background With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown.

Cited by 83 publications

References 12 publications

Debate: Why should gender-affirming health care be included in health science curricula?

Debate: Why should gender-affirming health care be included in health science curricula?

Sexual and gender minorities educational content within obstetric anesthesia fellowship programs: a survey

U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender‐Affirmation Education: A National Survey

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