Going to the doctor can be an uncomfortable and awkward experience for anyone, but that’s especially so for many transgender patients — and, as it turns out, for their physicians too.
That’s because doctors often lack the comfort level, experience, and training needed to provide transgender patients with quality care. According to a 2016 study on doctors and psychologists who specialize in transgender medicine, most reported feeling a level of “uncertainty” when it comes to treating transgender patients. In fact, lacking confidence and expertise does a disservice to transgender individuals.
To help change that, Boston University School of Medicine (BUSM) created a medical school elective that “combines the standard approach of teaching about transgender medical topics with sensitivity and appropriate terminology with evidence-based, hands-on patient care,” according to a press release from BUSM.
Students who had already participated in BUSM’s standard transgender care curriculum were offered the elective, which gave them the opportunity to work directly with transgender patients.
To find out how effective the class actually was, BUSM researchers then conducted a study, which appears in the journal Transgender Health, surveying the students about their knowledge and comfort level with transgender medical care both before and after taking the elective. The new study found that students who reported “high” comfort levels with treating transgender patients jumped from 45 to 80 percent after taking the class. Even students who were already familiar with transgender care benefitted from the hands-on patient care experience, according to the statement.
That’s a step in the right direction for transgender patients, who are typically medically underserved, according to the study’s co-author, Joshua D. Safer, MD, an associate professor of medicine at BUSM and medical director of the Center for Transgender Medicine and Surgery at Boston Medical Center. “In addition to the societal stigma, conventional medicine has considered transgender care to be a mental health concern for years,” Safer tells Yahoo Lifestyle. “Thus, standard medical programs did not teach transgender medicine.”
He continues: “Even now, when there is greater publicity in general, conventional medical programs often only teach terminology, which leaves open the possibility that transgender care remains a mental health concern only. The result is that transgender individuals continue to have difficulty finding doctors and other providers who know the medical approaches available.”
This lack of adequate training is a barrier to transgender individuals getting the care they need. “The standard teaching remains to review terminology, which may or may not be helpful and does little to train the students to provide care,” says Safer. “Some institutions have standardized patient situations, which may or may not reproduce reality well. A number of years ago at Boston University, we started teaching transgender medicine the way medicine is taught in general. Students learn the underlying science —as much as is known — the gaps in knowledge, and standard approaches based on that knowledge. That is more successful than the standard approach used elsewhere.”
The students also get invaluable hands-on experience with transgender patients. “We have added a component where the students spend time with transgender patients in our transgender clinic program — and it works,” says Safer. “Our study demonstrated that even when we start with students who felt knowledgeable about transgender care, the opportunity to apply their knowledge in real time with real people takes the students to a higher level.”
Safer says the elective raises transgender medicine training to the level of other medical topics. “Students have the opportunity to take what they’ve learned in formal settings and apply that knowledge in a practical clinical setting,” he says.
And that’s a win for both patients and physicians. “The more students feel as comfortable with transgender medical care as they do with other topics,” he says, “the easier it will be for transgender individuals to find safe, quality medical care.”
By: Rachel Grumman Bender