Poster Presentation The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2017

The effect of an educational session on attitudes toward delivery of transgender healthcare by medical students and general practitioners in the Hunter region (#180)

Maansi Arora 1 , Kaete Walker 2 3 4 , Robbert J Duvivier 5 , Katie Wynne 4 5 6 7
  1. University of New England, Armidale, NSW, Australia
  2. Hunter New England LHD Mental Health Service, Newcaste, NSW, Australia
  3. Executive Member Australian and New Zealand Professional Association for Transgender Health, (ANZPATH), Australia
  4. Hunter Centre for Sex and Gender Diversity, Newcastle, NSW, Australia
  5. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  6. Hunter Medical Research Institute, Newcastle, NSW, Australia
  7. Department of Diabetes & Endocrinology, John Hunter Hospital, Newcastle, NSW, Australia

The transgender community reports discrimination and lack of knowledge from their health-providers; both are identified as barriers to effective healthcare.1-8 However, health professionals receive little formal training in transgender health.9-14

A multidisciplinary team, including members of the transgender community, delivered a single education session to (a) year 3 medical students (MS) and (b) General Practitioners (GPs). Participants completed a questionnaire before and after the lecture about their capacity to deliver transgender healthcare15,16 A total of 81 MS and 50 GPs completed the pre-lecture survey; 79 MS and 43 GPs completed the post-lecture survey. Participants’ confidence to assist with adult transition care significantly improved after the session for both MS and GPs (see Figure). After the session more participants felt they were able to assist an adolescent requesting transition (MS 14% to 35%; GPs 10% to 57%; p<0.001); and provide support for a gender-questioning child (MS 15% to 29%; GPs 14% to 63%; p<0.001). The understanding of appropriate preventative cancer screening improved in MS (49% to 74%) and GPs (87% to 96%). A third of MS (33%) and half of GPs (49%) considered gender identity to be constant after adolescence and to have an underlying biological basis; this remained similar after education (MS 35%, p=0.17; GPs 55%, p=0.67). The positive safety/risk profile of hormonal and surgical treatment was found to be the most persuasive evidence for providing care. Following the intervention significantly more MS (49% to 75%; p=0.002) and GPs (77% to 84%; p=0.04) agreed that hormonal and surgical treatment should be offered to the transgender community.

A single educational session changed the attitudes of MS and GPs toward the delivery of transgender health. Access to competent healthcare improves the psychological and physical health of people with gender dysphoria.1,17,18 Transgender health training should be available to all health-providers7,15,16


  1. Sanchez NF, Sanchez JP, Danoff A. Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City. Am J Public Health. 2009;99:713-719.
  2. Winter S. Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region. United Nations Development Programme 2012. Accessed 29th April 2017.
  3. Hyde Z, Doherty M, Tilley PJM, McCaul KA, Rooney R, Jancey J. The First Australian National Trans Mental Health Study: Summary of Results. School of Public Health, Curtin University, Perth, Australia 2016.
  4. Smith E, Jones T, Ward R, Dixon J, Mitchell A and Hillier L. From Blues to Rainbows: Mental health and wellbeing of gender diverse and transgender young people in Australia. Melbourne: The Australian Research Centre in Sex, Health and Society 2014.
  5. Riggs DW, Coleman K, and Due C. Healthcare experiences of gender diverse Australians: a mixed-method, self-report survey. BMC Public Health 2014 14(230).
  6. Duvivier RJ, Wiley E. Health equity for LGBTQ people through education. Lancet 2016 2:387(10026):1375
  7. Reed T. GIRES: e-learning for transgender health training. Lancet 2016 388(10042):333.
  8. Winter S, Diamond M, Green J, Karasic D, Reed T, Whittle S, Wylie K. Transgender people: health at the margins of society. Lancet 2016 388(10042):390-400.
  9. Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students’ ability to care for lesbian, gay, bisexual and transgendered patient. Fam med 2006 38: 21-27.
  10. Obedin-Maliver J, Goldsmith ES, Stewart L, White W, Tran E, Brenman S, Wells M, Fetterman DM, Garcia G, Lunn MR. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA. 2011;306(9):971–977.
  11. Moll J, Krieger P, Moreno-Walton L, Lee B , Slaven E, James T, Hill D, Podolsky S, Corbin T, Heron SL. The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: what do we know? Acad Emerg Med. 2014;21(5):608–611.
  12. Irwig MS. Transgender care by endocrinologists in the United States. Endocr Pract. 2016;22(7):832–836.
  13. Davidge-Pitts C1, Nippoldt TB1, Danoff A2, Radziejewski L1, Natt N1.Transgender Health in Endocrinology: Current Status of Endocrinology Fellowship Programs and Practicing Clinicians. Clin Endocrinol Metab. 2017 Apr 1;102(4):1286-1290.
  14. Vance SR Jr, Hapern-Feisher BL, Rosenthal SM. Health care providers’ comfort with and barriers to care of transgender youth. J Adolesc Health 2015 56(2):251-3.
  15. Safer JD, Pearce EN. A simple curriculum content change increased medical student comfort with transgender medicine. Endocr Pract. 2013; 19:633-637.
  16. Thomas DD, Safer MD. A simple intervention raised resident-physician willingness to assist transgender patients seeking hormone therapy. Endocr Pract 2015; 21:1134-1142.
  17. Shill JE. Transgender care: transitioning the trainee. Endocr Pract 2015 21(10):1181-3.
  18. Marshall E, Claes L, Bouman WP, Wtcomb GL, Arcelus J. Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature. Int Rev Psychiatry 2016 28(1):58-69.