Advances in Medical Education and Practice (May 2018)
Transgender health care: improving medical students' and residents' training and awareness
Abstract
Samuel N Dubin,1,* Ian T Nolan,1,* Carl G Streed Jr,2 Richard E Greene,3 Asa E Radix,4 Shane D Morrison5 1NYU School of Medicine, New York, NY, 2Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, 3Department of Internal Medicine, NYU School of Medicine, 4Callen-Lorde Community Health Center, New York, NY, 5Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA *These authors contributed equally to this work Background: A 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. Methods: We 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. Results: Transgender 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. Conclusion: Transgender 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. Keywords: medical education, transgender, LGBT health, medical training, residency
