TransCare Initiative: An Institutional Knowledge-to-Action Project for Surgery and Gender Equity Education

BACKGROUND: The transgender/gender nonconform-ing (TGNC) population is growing exponentially, but surgeon education has not advanced accordingly. Our objective was to assess department-wide understanding, awareness, and comfort in treating TGNC patients and identify specific gaps in education and training needs.METHODS: A survey covering 4 domains (personal per-ceptions; prior healthcare training/experience; comfort providing care; barriers to access) regarding TGNC patients was distributed to surgery faculty and trainees at an urban referral center. The survey contained 24 5-point Likert scale and 6 multiple choice demographic items. There was a 4-week response window. Descrip-tive statistics assessed the relative frequency of responses. The main outcome measures were the gaps and variation in each domain.RESULTS: There was a 47.59% (89/187) response rate and split evenly between trainees and attendings. Over half (51.21%, n = 44) reported formal TGNC training, mainly in medical school (27.5%, n = 22). Most knew (72.41%, n = 63) and had experience caring for TGNC patients (74.71%, n = 65). There was disparity under-standing general concepts, with disagreement on defini-tions (8.99%, n = 8) and gender choice (14%, n = 12). Most reported comfort with communication, and could initiate conversations on pronouns (75.6%, n = 65) and gender identity (71.7%, n = 65). Over 40% could not complete a comprehensive history and admitted discom-fort performing physical exams. Despite this, 88.51% (n = 77) felt they could provide an adequate level of care. Most respondents recognized unique TGNC health risks (91.86%, n = 79) and access barriers (82.76%, n = 72), including providers' lack of TGNC cultural com-petency (82.76%, n = 72).CONCLUSION: Disparities existed across all domains needed for inclusive TGNC surgical care. Respondents were aware of unique health needs and barriers to access. Provider self-perceived experience did not match the knowledge and skill required to provide optimal care for TGNC patients. ( J Surg Ed 80:853-863. (c) 2023 Asso-ciation of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Automated summary

This study assessed the understanding, awareness, and comfort of surgery faculty and trainees in treating TGNC patients at an urban referral center. Disparities were found in knowledge, skills, and training needed for inclusive TGNC surgical care.