Transgender Medical Research and Provider Education Lacking

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 treatment 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 physicians 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 training program would increase access to safe care for transgender patients.