Suarez Sebastian, Lupton Lupez Emily, Modzelewski Katherine L, Hinkle Chad, Streed Carl G, Siegel Jennifer
Associate Program Director, UM/JMH Internal Medicine Residency Program, University of Miami Miller School of Medicine.
Assistant Professor of Medicine, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine.
MedEdPORTAL. 2025 Jun 17;21:11535. doi: 10.15766/mep_2374-8265.11535. eCollection 2025.
Internal medicine (IM) residents often lack the knowledge, comfort, and competency to care for gender and sexual diverse (GSD) patients, contributing to health disparities. We developed a practical, evidence-based framework providing residents with a systematic, stepwise approach to addressing GSD health needs.
The curriculum was implemented at an urban safety-net hospital for 46 IM residents. Two 2-hour sessions utilized a case-based, small-group, interactive scenario of a transgender woman requiring screening and treatment of sexually transmitted illnesses (STIs), pre-exposure prophylaxis (PrEP) prescription, and gender-affirming hormone therapy (GAHT) initiation. One-page handouts with step-by-step instructions were provided. Surveys evaluated knowledge, attitudes toward the importance of GSD care, and perceptions of confidence in performing specific skills related to GSD care. Wilcoxon signed-rank tests were used to compare pre- and postsession answers.
Residents' perceived confidence in providing GSD sexual health care and prescribing PrEP and GAHT increased after the sessions ( < .001). Attitudes regarding the importance of obtaining comprehensive sexual histories, discussing gender identity, assessing gender dysphoria, and offering GAHT for GSD patients also increased ( < .001). The median number of correct responses to five knowledge-based questions increased from 1 to 4 ( < .001).
This curriculum improved residents' perceptions of the importance of providing GSD care, as well as their knowledge and confidence in clinical skills related to STI screening and treatment, PrEP prescription, and GAHT initiation. This curriculum offers IM residents one of the first systematic frameworks, with immediately useable materials, to address GSD health.
内科住院医师通常缺乏照顾性别和性取向多元（GSD）患者的知识、舒适度和能力，这加剧了健康差距。我们开发了一个实用的、基于证据的框架，为住院医师提供一种系统的、逐步的方法来满足GSD患者的健康需求。
该课程在一家城市安全网医院针对46名内科住院医师实施。两个2小时的课程采用了基于案例的小组互动情景，内容是一名跨性别女性需要进行性传播感染（STIs）筛查和治疗、暴露前预防（PrEP）处方以及启动性别确认激素治疗（GAHT）。提供了带有逐步说明的单页手册。通过调查评估知识、对GSD护理重要性的态度以及对执行与GSD护理相关的特定技能的信心感知。使用Wilcoxon符号秩检验来比较课前和课后的答案。
课程结束后，住院医师在提供GSD性健康护理以及开具PrEP和GAHT方面的自信心有所提高（<.001）。对于获取全面性病史、讨论性别认同、评估性别焦虑以及为GSD患者提供GAHT的重要性的态度也有所提高（<.001）。对五个基于知识的问题的正确回答中位数从1增加到了4（<.001）。
该课程提高了住院医师对提供GSD护理重要性的认识，以及他们在与STI筛查和治疗、PrEP处方以及GAHT启动相关的临床技能方面的知识和信心。该课程为内科住院医师提供了首批系统框架之一，包含可立即使用的材料，以解决GSD健康问题。
