Reproductive endocrinologist and infertility specialists’ knowledge, skills, behaviors, and attitudes regarding the care for transgender and gender-diverse individuals
Pip Lipkin, M.D.,
Brent Monseur, M.D., Sc.M.,
Jonathan Mayo, M.P.H.,
Molly Moravek, M.D.,
Leena Nahata, M.D.,
Paula Amato, M.D.,
Ruben Alvero, M.D.,
Juno Obedin-Maliver, M.D., M.P.H., M.A.S.
Affiliations
Pip Lipkin, M.D.
Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York; Correspondence: Pip Lipkin, M.D., Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, 462 1st Ave, NBV 9E, New York, New York 10016.
Brent Monseur, M.D., Sc.M.
Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility Division, Stanford University School of Medicine, Palo Alto, California
Jonathan Mayo, M.P.H.
Dunlevie Maternal-Fetal Medicine Center for Discovery, Innovation and Clinical Impact, Stanford University School of Medicine, Stanford, California
Molly Moravek, M.D.
Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility Division, University of Michigan Medical School, Ann Arbor, Michigan
Leena Nahata, M.D.
Division of Pediatric Endocrinology, Nationwide Children’s Hospital, Columbus, Ohio
Paula Amato, M.D.
Department of Obstetrics and Gynecology, Oregon Health Science University School of Medicine, Portland, Oregon
Ruben Alvero, M.D.
Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility Division, Stanford University School of Medicine, Palo Alto, California
Juno Obedin-Maliver, M.D., M.P.H., M.A.S.
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
Objective: To investigate associations between reproductive endocrinology and infertility (REI) providers’ prior training and current knowledge, skills, attitudes, and behaviors regarding fertility preservation and family building for transgender and gender-diverse (T/GD) patients. Design: The survey was distributed to members of the Society for Reproductive Endocrinology and Infertility, the REI-physician-focused professional body within the American Society for Reproductive Medicine, with additional participants recruited through snowball sampling. Results: Participants (n = 206) reported on training in T/GD care; 51% endorsed prior training. Most participants (93%) believed T/GD individuals were as fit for parenthood as cisgender individuals. Prior training was associated with an increased likelihood of offering T/GD health resources and more frequent consultations with specialist colleagues.Common barriers to providing care indicated by respondents included cost, delays in gender-affirming care, and lack of knowledge of the potential impact of hormonal interventions. Common facilitators included education and training, prior experience, and affordability of services. Conclusions: Most REI providers believed T/GD individuals are fit for parenthood and agreed that prior training facilitates care for T/GD patients. The lack of provider knowledge emerged as a barrier to care. Although training helped facilitate some components of care, systemic barriers such as the cost and variability of patient population characteristics/experiences are important considerations when serving T/GD individuals.
