Jack L Turban1, Joel Winer2, Susan Boulware3, Timothy VanDeusen3,4, John Encandela4,5. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. 2. Obstetrics, Gynecology & Reproductive Services, Yale School of Medicine, New Haven, Connecticut, USA. 3. Pediatric Gender Program, Yale School of Medicine, New Haven, Connecticut, USA. 4. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. 5. Teaching and Learning Center, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Abstract
BACKGROUND: Hormonal interventions for transgender adolescents have become increasingly common; however, there is a paucity of research on medical student knowledge of, and attitudes toward, these interventions following didactic instruction. Furthermore, no studies have examined whether students can be aware of the literature on the mental health benefits of these treatments yet continue to find them unethical. METHODS: An anonymous online survey was administered to students, from first to fourth year (n = 407), who had received one or two lectures on the treatment of youths with gender dysphoria (GD). RESULTS: Surveys were completed by 162 respondents (40%). A majority was able to correctly answer questions regarding psychiatric co-morbidities, diagnostic criteria, hormonal interventions, long-term benefits of interventions and terminology. There was some evidence that precision in the use of terminology waned over time. Many were unclear on the role of puberty blockers and the time requirement for a diagnosis of GD. A minority (14%) reported a belief that hormonal therapy is unethical, although these same individuals recognised that these treatments have mental health benefits. DISCUSSION: Our results have implications for future instruction, including: the need to teach pharmacological and diagnostic issues more deliberately; providing refresher training on terminology; and relying on interactive discussion or patient visits, rather than didactic lectures alone, for ethically charged medical topics. Similar levels of knowledge among students who believe that hormonal therapy is ethical and unethical may indicate that imparting didactic knowledge about therapeutic benefits alone may not be sufficient to affect attitudes regarding endocrine care for transgender youth. Hormonal interventions for transgender adolescents have become increasingly common.
BACKGROUND: Hormonal interventions for transgender adolescents have become increasingly common; however, there is a paucity of research on medical student knowledge of, and attitudes toward, these interventions following didactic instruction. Furthermore, no studies have examined whether students can be aware of the literature on the mental health benefits of these treatments yet continue to find them unethical. METHODS: An anonymous online survey was administered to students, from first to fourth year (n = 407), who had received one or two lectures on the treatment of youths with gender dysphoria (GD). RESULTS: Surveys were completed by 162 respondents (40%). A majority was able to correctly answer questions regarding psychiatric co-morbidities, diagnostic criteria, hormonal interventions, long-term benefits of interventions and terminology. There was some evidence that precision in the use of terminology waned over time. Many were unclear on the role of puberty blockers and the time requirement for a diagnosis of GD. A minority (14%) reported a belief that hormonal therapy is unethical, although these same individuals recognised that these treatments have mental health benefits. DISCUSSION: Our results have implications for future instruction, including: the need to teach pharmacological and diagnostic issues more deliberately; providing refresher training on terminology; and relying on interactive discussion or patient visits, rather than didactic lectures alone, for ethically charged medical topics. Similar levels of knowledge among students who believe that hormonal therapy is ethical and unethical may indicate that imparting didactic knowledge about therapeutic benefits alone may not be sufficient to affect attitudes regarding endocrine care for transgender youth. Hormonal interventions for transgender adolescents have become increasingly common.
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