(Q30473)
Statements
Family physicians are increasingly more likely to encounter transgender and gender-diverse (TGD) patients requesting gender-affirming care. (English)
Given the significant health inequities faced by the TGD community, this study aimed to assess changes in military-affiliated clinicians' perspectives toward gender-affirming care over time. (English)
Using a serial cross-sectional survey design of physicians at the 2016 and 2023 Uniformed Services Academy of Family Physicians conferences, we studied participants' perception of, comfort with, and education on gender-affirming care using Fisher's Exact tests and logistic regression. (English)
Response rates were 68% (n = 180) and 69% (n = 386) in 2016 and 2023, respectively. (English)
Compared to 2016, clinicians in 2023 were significantly more likely to report receiving relevant education during training, providing care to >1 patient with gender dysphoria, and being able to provide nonjudgmental care. (English)
In 2023, 26% reported an unwillingness to prescribe gender-affirming hormones (GAH) to adults due to ethical concerns. (English)
In univariable analysis, female-identifying participants were more likely to report willingness to prescribe GAH (OR = 2.6, 95%CI = 1.7-4.1) than male-identifying participants. (English)
Willingness to prescribe was also associated with ≥4 h of education (OR = 2.2, 95%CI = 1.1-4.2) compared to those with fewer than 4 h, and those who reported the ability to provide nonjudgmental care compared to those who were neutral (OR = 0.09, 95%CI = 0.04-0.2) or disagreed (OR = 0.11, 95%CI = 0.03-0.39). (English)
Female-identifying clinicians were more likely to agree additional training would benefit their practice (OR = 5.3, 95%CI = 3.3-8.5). (English)
Although military-affiliated family physicians endorsed more experience with and willingness to provide nonjudgmental gender-affirming care in 2023 than 2016, profound gaps in patient experience may remain based on the assigned clinician. (English)
Additional training opportunities should be available, and clinicians unable to provide gender-affirming care should ensure timely referrals. (English)
Future research should explore trends across clinical specialties. (English)
Kryls O (English)
Domalaon (English)
KO
Austin M (English)
Parsons (English)
AM
Jennifer A (English)
Thornton (English)
JA
Kent H (English)
Do (English)
KH
Christina M (English)
Roberts (English)
CM
Natasha A (English)
Schvey (English)
NA
David A (English)
Klein (English)
DA
15 August 2024
12 August 2024
Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors have no conflicts of interest to disclose. (English)
Dr. Roberts has previously received funding from Organon for contraception research (Organon investigator initiated grant program). (English)