Unger Cécile A
Center for Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics & Gynecology, Women's Health Institute, Cleveland Clinic , Cleveland, Ohio.
J Womens Health (Larchmt). 2015 Feb;24(2):114-8. doi: 10.1089/jwh.2014.4918. Epub 2014 Dec 19.
Medical school and residency curricula are lacking in content on the care of the transgender patient. As a result, many providers do not have enough experience and knowledge to adequately care for this patient population. The aim of this study was to assess gynecologists' preferences and knowledge base with regard to transgender healthcare.
This was a cross-sectional survey of obstetrics and gynecology (OBGYN) providers. An anonymous survey was sent via electronic mail to nine academic OBGYN departments across the United States. Survey questions were designed to assess provider experience and practice environment, education about transgender health practices, personal experience with transgender patients, and knowledge base regarding current recommendations for the care of gender minority patients.
Of the 352 providers who received the survey, 141 responded, for a 40.1% response rate. Of the respondents, 61.7% (87 of 141) were generalist OBGYNs, and 86% (117 of 136) practiced in an academic institution; 80% (113 of 141) did not receive training in residency on the care of transgender patients. Time in practice was not associated with having learned about transgender care. Only 35.3% and 29% were comfortable caring for male-to-female and female-to-male transsexual patients, respectively; and, 88.7% and 80.4% were willing to perform screening Pap smears on female-to-male transsexual patients and routine breast examinations on male-to-female patients, respectively. Eighty-two of 138 providers (59.4%) did not know the recommendations for breast cancer screening in male-to-female patients.
Efforts should be made to educate trainees on the important aspects of transgender care, and comprehensive guidelines should be published for practicing providers.
医学院校和住院医师培训课程缺乏有关跨性别患者护理的内容。因此，许多医疗服务提供者没有足够的经验和知识来充分照顾这一患者群体。本研究的目的是评估妇科医生在跨性别医疗保健方面的偏好和知识基础。
这是一项对妇产科（OBGYN）医疗服务提供者的横断面调查。通过电子邮件向美国九个学术性妇产科部门发送了一份匿名调查问卷。调查问题旨在评估医疗服务提供者的经验和执业环境、跨性别健康实践教育、与跨性别患者的个人经历以及关于当前性别少数群体患者护理建议的知识基础。
在收到调查问卷的352名医疗服务提供者中，141人回复，回复率为40.1%。在回复者中，61.7%（141人中的87人）是普通妇产科医生，86%（136人中的117人）在学术机构执业；80%（141人中的113人）在住院医师培训期间未接受过跨性别患者护理方面的培训。执业时间与学习跨性别护理无关。分别只有35.3%和29%的人对护理男变女和女变男的变性患者感到自在；并且，分别有88.7%和80.4%的人愿意为女变男的变性患者进行巴氏涂片筛查，为男变女的患者进行常规乳房检查。138名医疗服务提供者中有82人（59.4%）不知道男变女患者乳腺癌筛查的建议。
应努力对实习生进行跨性别护理重要方面的教育，并为执业医疗服务提供者发布全面的指南。
