Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.

Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) (=0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (<0.001. Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.