Ha Michael, Ngaage Ledibabari M, Finkelstein Emily R, Simon Caroline, Hricz Nicholas, Zhu Kevin, Yoon Joshua, Liang Fan, Berli Jens, Rasko Yvonne
Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Transgend Health. 2025 Feb 10;10(1):44-51. doi: 10.1089/trgh.2022.0206. eCollection 2025 Feb.
Over 1.4 million American adults identify as transgender or nonbinary. Of these transgender persons, up to half will seek gender-affirmation surgery. The literature is void regarding the current state of gender-affirming surgical training provided to plastic surgery residents. This study reviews the quantity and type of transgender surgical education in American plastic surgery residency programs.
We performed a cross-sectional analysis on all accredited independent and integrated plastic surgery residency programs. Information on program curricula was collected from official program websites and email or telephone interviews with program coordinators. Education was categorized into didactic, clinical, or elective. Programs were classified according to geography and affiliation with a "Leaders in LGBT Healthcare" center.
This study included 130 programs. While 58% of programs provided clinical training (=75), significantly fewer had didactic teaching (=50, 38%; <0.003). One in five programs (=15, 20%) that provided clinical training had a dedicated rotation. Programs affiliated with "Leaders in LGBT Healthcare" centers were significantly more likely to provide both didactic (=33=17; =0.031) and clinical training (=48, =27; =0.006). Forty-two percent (=54) of programs had no formal gender-affirmation surgery education and no scheduled elective time to acquire it.
Despite the growing demand for gender-affirmation surgery, a large percentage of plastic surgery residency programs do not have didactic or clinical training and no elective means by which to acquire it. Institutional features, including "Leader in LGBT Healthcare Equality" status and geographic location, can significantly influence the type of gender transition education in residency.
超过140万美国成年人认定自己为跨性别者或非二元性别者。在这些跨性别者中，多达一半的人会寻求性别肯定手术。关于为整形外科住院医师提供的性别肯定手术培训的现状，文献中尚无相关内容。本研究回顾了美国整形外科住院医师培训项目中跨性别手术教育的数量和类型。
我们对所有经认可的独立和综合整形外科住院医师培训项目进行了横断面分析。从项目官方网站以及与项目协调员的电子邮件或电话访谈中收集有关项目课程的信息。教育分为理论教学、临床教学或选修。项目根据地理位置和与“LGBT医疗保健领导者”中心的关联进行分类。
本研究纳入了130个项目。虽然58%的项目提供临床培训（n = 75），但进行理论教学的项目明显较少（n = 50，38%；P < 0.003）。提供临床培训的项目中，五分之一（n = 15，20%）有专门的轮转安排。与“LGBT医疗保健领导者”中心相关联的项目更有可能同时提供理论教学（n = 33，占17个中心的比例；P = 0.031）和临床培训（n = 48，占27个中心的比例；P = 0.006）。42%（n = 54）的项目没有正式的性别肯定手术教育，也没有获取此类教育的预定选修时间。
尽管对性别肯定手术的需求不断增加，但很大一部分整形外科住院医师培训项目没有理论教学或临床培训，也没有获取此类培训的选修途径。机构特征，包括“LGBT医疗保健平等领导者”地位和地理位置，可显著影响住院医师培训中性别转换教育的类型。
