Transgender medical research and provider education lacking

December 11, 2013, Boston University Medical Center

As a result of the limited transgender medical training offered at medical schools, very few physicians possess the knowledge needed to treat transgendered patients. This circumstance is the topic of a paper in this month's issue Current Opinion in Endocrinology, Diabetes and Obesity.

Joshua Safer, MD, FACP, associate professor of medicine at Boston University School of Medicine (BUSM) and Director of the Endocrinology Fellowship Training Program at Boston Medical Center, is the senior author of the piece which includes guidelines for transgender and also references the impact of recently piloted teaching on the topic at BUSM.

There are approximately 900,000 transgender persons living in the U.S. These individuals have a unique set of medical needs because their gender identities do not correlate with their biological sex. Medical interventions such as hormone therapy are required to appropriately and safely address the health of transgender patients.

According to Safer while many of the treatment regimens for transgender patients are fairly straightforward, very few physicians have the knowledge needed to treat these individuals. In fact, many physicians share the misconception that transgender treatment is a psychological issue and that gender identity can be reversed—an assumption that has been discredited.

"Because medically appropriate high-quality care for transgender individuals is not taught in most medical curricula, too few physicians have the requisite knowledge and comfort level for treatment of transgender individuals," explained Safer.

Safer has recently piloted a transgender medicine component to the pathophysiology curriculum for medical school students at BUSM. According to pre- and post-course surveys published this summer in the journal Endocrine Practice, there was a 67 percent improvement among students enrolled in his course regarding their confidence with transgender medicine.

Safer is working to develop comprehensive transgender medicine training curricula for medical students, physician trainees, teaching and other health care professionals. to address the specific biological distinctions of the patient group and evidence-based treatment paradigms derived from that biology. This would increase access to safe care for transgender patients.

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lsinbc
not rated yet Dec 11, 2013
This is unsettling but not surprising. I live in British Columbia, where our provincial medical services plan pays for GRS, yet even the medical training at the University of British Columbia is seriously lacking with respect to transgender health. I recently went for my semi annual check up and my doctor asked if I would mind a pre-med student to sit in. I agreed on the condition I could ask questions. I asked the young male student how much trans related instruction he had received and he said none, with the exception of a brief mention in one of the lectures. I implored him to complain to his faculty and congratulated him for wanting to observe at a trans health office. No wonder so many trans people I know in Vancouver have had problems finding medical professionals that are informed and welcoming. I sad to say that it seems like the opposite is true, even in this seemingly progressive jurisdiction.

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