Krueger Merry E, Roque Remigio A, Reece-Nguyen Travis L, MacCormick Hilary
Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Department of Anesthesiology and Pain Medicine, University of Washington, Washington, USA.
Paediatr Anaesth. 2025 Mar;35(3):207-214. doi: 10.1111/pan.15053. Epub 2024 Dec 7.
Transgender and gender-diverse individuals experience higher burdens of health disparities compared to their cisgender counterparts. Contributing factors include decreased access and denial of care, experiences and fear of medical violence, and increasing legislative barriers. These patients often report having to educate healthcare professionals due to lack of expertise of transgender and gender-diverse issues within the medical community, with training deficits observed at all levels of medical training.
We surveyed pediatric anesthesiology fellowship directors in the United States and Canada with an aim to describe the current state of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content across pediatric anesthesiology fellowship training programs.
A 25-question descriptive, cross-sectional, electronic survey was created and distributed to all pediatric anesthesiology fellowship program directors in the United States and Canada investigating the inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum (if present) for pediatric anesthesiology fellows.
A total of 33 responses were collected from 69 total invited programs. Diversity, equity, and inclusion curricula were present in 93.5% (29/31) of fellowship programs but only 29% (9/31) of programs included content specific to transgender and gender-diverse populations. Just 17% (5/29) of program directors thought their curriculum adequately prepared their graduates to care for transgender and gender-diverse patients. However, 69% (20/29) expressed a desire to see more educational content included in the future. Lack of knowledgeable faculty educators and time were the most chosen perceived barriers to inclusion.
To our knowledge, this study is the first to evaluate pediatric anesthesiology fellowship curricula for inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum. As the population of known transgender and gender-diverse youth increases, all pediatric anesthesiologists must be equipped to treat this population with appropriate clinical and cultural sensitivity. Future endeavors must include robust sexual orientation and gender identity data collection, access to educational materials from content experts, recruitment and empowerment of LGBTQ+ anesthesiologists, and increased dedicated time toward diversity, equity, and inclusion education, specifically in regard to the transgender and gender-diverse population.
Lack of physician education on the care of transgender and gender-diverse patients is one of several factors contributing to the health disparities seen in this population; training deficits in the care of transgender and gender-diverse patients have been observed in all levels of medical training. Our data show a critical deficiency of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content in pediatric anesthesiology fellowships in the United States and Canada and identify potential barriers to the inclusion of such content.
与顺性别者相比，跨性别和性别多样化个体面临着更高的健康差距负担。促成因素包括医疗服务获取减少和拒绝提供护理、医疗暴力经历和恐惧，以及日益增加的立法障碍。这些患者经常报告说，由于医学界缺乏跨性别和性别多样化问题的专业知识，他们不得不对医疗保健专业人员进行教育，而且在医学培训的各个层面都存在培训不足的情况。
我们对美国和加拿大的儿科麻醉学专科培训项目主任进行了调查，旨在描述儿科麻醉学专科培训项目中，跨性别和性别多样化主题在多样性、公平性和包容性课程内容中的现状。
设计了一份包含25个问题的描述性横断面电子调查问卷，并分发给美国和加拿大所有儿科麻醉学专科培训项目主任，调查儿科麻醉学专科培训生的多样性、公平性和包容性课程（如有）中是否包含跨性别和性别多样化主题。
在总共69个受邀项目中，共收集到33份回复。93.5%（29/31）的专科培训项目设有多样性、公平性和包容性课程，但只有29%（9/31）的项目包含针对跨性别和性别多样化人群的内容。只有17%（5/29）的项目主任认为他们的课程能让毕业生充分准备好照顾跨性别和性别多样化患者。然而，69%（20/29）的人表示希望未来能纳入更多教育内容。缺乏知识渊博 的教员和时间是最常被提及 的纳入此类内容的障碍。
据我们所知，本研究是首次评估儿科麻醉学专科培训课程中，跨性别和性别多样化主题在多样性、公平性和包容性课程中的纳入情况。随着已知的跨性别和性别多样化青少年数量的增加，所有儿科麻醉医生都必须具备以适当的临床和文化敏感性治疗这一人群的能力。未来的努力必须包括强有力的性取向和性别认同数据收集、获取内容专家提供的教育材料、招募和支持 LGBTQ+ 麻醉医生，以及增加专门用于多样性、公平性和包容性教育的时间，特别是针对跨性别和性别多样化人群的教育。
医生在照顾跨性别和性别多样化患者方面缺乏教育，是导致这一人群健康差距的几个因素之一；在医学培训的各个层面都观察到在照顾跨性别和性别多样化患者方面存在培训不足的情况。我们的数据显示，在美国和加拿大的儿科麻醉学专科培训中，多样性、公平性和包容性课程内容中跨性别和性别多样化主题严重不足，并确定了纳入此类内容的潜在障碍。
