Turban Jack L, Winer Joel, Boulware Susan, VanDeusen Timothy, Encandela John
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Obstetrics, Gynecology & Reproductive Services, Yale School of Medicine, New Haven, Connecticut, USA.
Clin Teach. 2018 Jun;15(3):203-207. doi: 10.1111/tct.12738. Epub 2017 Nov 27.
Hormonal interventions for transgender adolescents have become increasingly common; however, there is a paucity of research on medical student knowledge of, and attitudes toward, these interventions following didactic instruction. Furthermore, no studies have examined whether students can be aware of the literature on the mental health benefits of these treatments yet continue to find them unethical.
An anonymous online survey was administered to students, from first to fourth year (n = 407), who had received one or two lectures on the treatment of youths with gender dysphoria (GD).
Surveys were completed by 162 respondents (40%). A majority was able to correctly answer questions regarding psychiatric co-morbidities, diagnostic criteria, hormonal interventions, long-term benefits of interventions and terminology. There was some evidence that precision in the use of terminology waned over time. Many were unclear on the role of puberty blockers and the time requirement for a diagnosis of GD. A minority (14%) reported a belief that hormonal therapy is unethical, although these same individuals recognised that these treatments have mental health benefits.
Our results have implications for future instruction, including: the need to teach pharmacological and diagnostic issues more deliberately; providing refresher training on terminology; and relying on interactive discussion or patient visits, rather than didactic lectures alone, for ethically charged medical topics. Similar levels of knowledge among students who believe that hormonal therapy is ethical and unethical may indicate that imparting didactic knowledge about therapeutic benefits alone may not be sufficient to affect attitudes regarding endocrine care for transgender youth. Hormonal interventions for transgender adolescents have become increasingly common.
针对跨性别青少年的激素干预措施已日益普遍；然而，关于医学生在接受教学指导后对这些干预措施的了解及态度的研究却很少。此外，尚无研究考察学生是否知晓有关这些治疗对心理健康有益的文献，但仍认为它们不符合伦理道德。
对一至四年级的学生（n = 407）进行了一项匿名在线调查，这些学生曾接受过一两次关于性别焦虑症（GD）青少年治疗的讲座。
162名受访者（40%）完成了调查。大多数人能够正确回答有关精神疾病共病、诊断标准、激素干预、干预的长期益处和术语的问题。有证据表明，随着时间的推移，术语使用的准确性有所下降。许多人不清楚青春期阻滞剂的作用以及GD诊断的时间要求。少数人（14%）表示认为激素治疗不符合伦理道德，尽管这些人也认识到这些治疗对心理健康有益。
我们的结果对未来的教学具有启示意义，包括：需要更有针对性地教授药理学和诊断问题；提供术语复习培训；对于涉及伦理的医学主题，依靠互动讨论或患者访视，而不是仅靠教学讲座。认为激素治疗符合伦理道德和不符合伦理道德的学生在知识水平上相近，这可能表明仅传授关于治疗益处的教学知识可能不足以影响对跨性别青少年内分泌护理的态度。针对跨性别青少年的激素干预措施已日益普遍。
