Clinical Medicine Training Preps Med Students to Treat Transgender Patients

Joshua David Safer, MD, the medical director of the Center for Transgender Medicine and Surgery

Joshua David Safer, MD

A new study from Boston University School of Medicine suggests that medical students who are specifically trained in clinical transgender medicine are better prepared to treat transgender patients.

Study authors demonstrated that specific transgender medicine content in a medical school curriculum increase student’s willingness to treat transgender patients aside from what’s seen with cultural competency training alone.

“The number one barrier to quality transgender medical care is the lack of trained clinicians,” co-study authors Jason Andrew Park, medical student, and Joshua David Safer, MD, medical director, Center of Transgender Medicine and Surgery, said in a statement. “Transgender individuals are medically underserved in the US and face many documented disparities in care due to providers’ lack of education, training and comfort.”

Augmenting Boston University School of Medicine’s mandatory training of medical students in gender identity and transgender medicine, researchers piloted a Transgender Medicine elective, where fourth-year medical students rotate on services providing clinical care for transgender individuals.

Researchers also found that those same students are less comfortable providing transgender care relative to care for lesbian, gay and bisexual (LGB) patients.

The 20 students had already taken part in an elective in which methods of providing transgender medical care were learned. Pre- and post-surveys were administered to students that participated in the elective, and all students completed both surveys.

At baseline, students unanimously expressed the opinion that to make high-quality gender minority care a reality, medical schools and residency programs need to provide training in transgender health.

Once completing the elective, students who reported “high” comfort increased from 45% to 80% (p=.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% to 85% (p <.001).

Findings indicated that the number of students who reported “low” skills in providing general care decreased from 35% to 0% (p <.001), while the number of students that reported “low” skills providing hormone treatment for transgender patients also decreased from more than half to 1 student (5%) (p<.001).

Even though the study indicates that assimilating transgender-specific content into medical curricula improves student knowledge and comfort, gaps persist even among students reporting interest in providing care.

“Boston University School of Medicine introduced a clinical elective where students can participate in direct medical care for transgender patients,” Park and Safer noted. “The students who participated in the elective reported greater confidence in providing care to transgender individuals than the same students had reported from classroom instruction alone.”

Clinical exposure during training can aid in closing the gap between transgender and LGB care and improve access to the transgender population.

Study results were presented at ENDO 2018 — the 100^th annual meeting of Endocrine Society.