Ludwig David C, Dodson Thomas B, Morrison Shane D
David C. Ludwig, DDS, MD, is a Resident, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry; Thomas B. Dodson, DMD, MPH, FACS, is Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry; and Shane D. Morrison, MD, MS, is a Resident, Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine.
J Dent Educ. 2019 Jan;83(1):103-111. doi: 10.21815/JDE.019.013.
With a growing number of individuals seeking gender-affirming surgery, there is a greater need for providers, including oral and maxillofacial surgeons, experienced in the surgical care of transgender people. The aim of this study was to evaluate oral and maxillofacial surgery (OMS) residents' exposure to the care of transgender people and their perceived importance of education in gender-affirming surgery. All 1,174 OMS residents in accredited U.S. training programs were invited to participate in this cross-sectional study between July 1, 2017, and January 30, 2018. The predictor variables were residents' gender, program region, program type, and level of training. The outcome variables were frequency of exposure to the care of transgender people, aspects of care covered, perceived importance of such training, and perceived need for fellowship opportunities in gender-affirming surgery. Results were analyzed for 87 respondents, for a 7.4% response rate. Among the respondents, 81.6% were male; 64.4% were training in combined MD degree-OMS certificate programs; and 31% reported having had exposure to the care of transgender people during their residency. On a scale from 1=neutral to 3=very important, the respondents' mean reported importance of receiving training in gender-affirming surgery was 1.37±0.94. Also, 37.9% reported that fellowship training should be offered in gender-affirming surgery, specifically facial feminization/masculinization. These results showed that the OMS residents had had limited exposure to the care of transgender people, but they perceived that such exposure should be an important component of their training. Further research is needed to collect results from a larger sample and to better understand the role of oral and maxillofacial surgeons in gender-affirmation surgery.
随着越来越多的人寻求性别肯定手术，对包括口腔颌面外科医生在内的、有经验为跨性别者提供手术护理的医疗服务提供者的需求也日益增加。本研究的目的是评估口腔颌面外科（OMS）住院医师接触跨性别者护理的情况，以及他们对性别肯定手术教育的认知重要性。2017年7月1日至2018年1月30日期间，邀请了美国所有1174名参加经认可培训项目的OMS住院医师参与这项横断面研究。预测变量为住院医师的性别、项目地区、项目类型和培训水平。结果变量包括接触跨性别者护理的频率、所涵盖的护理方面、此类培训的认知重要性，以及对性别肯定手术专科培训机会的认知需求。对87名受访者的结果进行了分析，回复率为7.4%。在受访者中，81.6%为男性；64.4%参加的是医学博士学位-OMS证书联合培训项目；31%报告在住院实习期间接触过跨性别者的护理。在从1（中立）到3（非常重要）的量表上，受访者报告接受性别肯定手术培训的平均重要性评分为1.37±0.94。此外，37.9%的受访者表示，应该提供性别肯定手术方面的专科培训，特别是面部女性化/男性化方面的培训。这些结果表明，OMS住院医师接触跨性别者护理的机会有限，但他们认为这种接触应该是他们培训的重要组成部分。需要进一步研究以收集更大样本的结果，并更好地了解口腔颌面外科医生在性别肯定手术中的作用。
