Elsevier

Endocrine Practice

Volume 24, Issue 12, December 2018, Pages 1038-1042
Endocrine Practice

Original Articles
Endocrinology Fellows' Perception of Their Confidence and Skill Level in Providing Transgender Healthcare

https://doi.org/10.4158/EP-2018-0307Get rights and content

ABSTRACT

Objective: Both educational content and hours devoted to transgender health training of endocrinology fellows are suboptimal. The objective of this study was to assess the perspectives of endocrinology fellows on their training in transgender health.

Methods: We evaluated the state of comfort and knowledge of transgender healthcare among endocrinology fellows attending Endocrine University. Surveys were administered to fellows before and after their participation in a case-based session on transgender health.

Results: The majority of fellows felt that training in transgender health is important (95.9%, 189/197); however, only 58.9% reported inclusion of dedicated transgender content in their training programs. Fellows who had received transgender healthcare education, and those who had seen more transgender patients in their training, were more likely to be confident in treating patients with hormone therapy (P<.001 and P<.0001, respectively). Following the case-based session, 62.4 % of fellows reported that they would change their practice, 72.8% felt that their comfort level with transgender care had improved, and 91% felt that transgender content such as that provided in the educational session should be mandatory in endocrinology training programs. Methods most desired by fellows to improve their education included lectures from visiting professors (70.3%), participation in elective rotations (62.1%), online training modules (57.9%), and attendance at meetings with transgender topics (57.4%).

Conclusion: Transgender health education of U.S. endocrinology fellows is suboptimal. Participation in a case-based session significantly increased the comfort level of endocrinology fellows in key areas of transgender health.

Abbreviation: ACGME = Accreditation Council for Graduate Medical Education

Section snippets

INTRODUCTION

Approximately 1.4 million Americans identify as transgender (1), and many of these individuals will seek care for gender dysphoria/gender incongruence. Insurance coverage for transgender services has improved over recent years, with subsequent increased demand for providers with competence in transgender healthcare. Considering the central role of endocrinologists in treating gender dysphoria/gender incongruence, it is essential that endocrinology fellows receive the necessary training to

METHODS

The American Association of Clinical Endocrinologist hosts the annual Endocrine University, a 6-day educational course for endocrinology fellows in their final year of training. The goal of Endocrine University is to help prepare fellows for clinical practice by enhancing their exposure to key content areas that might not readily be available in fellowship training. In 2017, transgender education was added as new content. That year, 275 final year fellows attended the Endocrine University,

RESULTS

The general characteristics of responding fellows are shown in Table 1.

DISCUSSION

Endocrinologists play an integral role in the management of transgender patients (16). A 2-hour didactic case-based session provided to endocrinology fellows significantly increased their reported comfort level in managing key areas of transgender healthcare. However, despite this increase, the postsession number of fellows who felt comfortable with transgender care remained unacceptably low. Our results showed that fellows had a low baseline level of confidence in nonendocrine content areas

CONCLUSION

Our study describes the current state of transgender healthcare education from the perspective of endocrine fellows attending Endocrine University. Many fellows do not have adequate exposure to transgender health content, and for those that do, hours and content areas are suboptimal. This is concerning in the setting of rising healthcare needs of transgender patients. A didactic case-based session on transgender healthcare presented at Endocrine University significantly improved fellows'

REFERENCES (21)

There are more references available in the full text version of this article.

See accompanying article, p. 1106.

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