Genital gender-affirming surgery for transmasculine & nonbinary patients: Impact of a resident educational course

Background: Despite a high national demand for genital gender-affirming surgery, training within United States obstetrics and gynecology (OB/GYN) residencies is limited. Method: OB/GYN residents from eight programs, including two programs in each geographic area of the United States, participated in a standardized, clinical scenario-based educational module on genital gender-affirming surgery for transmasculine and nonbinary patients from August 2022 to July 2023. Residents completed pre- and post-surveys associated with this educational module. Results: Eighty-three residents participated in the course, including thirty-two (38.6%) from the Midwest, thirty (36.1%) from the Northeast, thirteen (15.7%) from the South, and eight (9.6%) from the West. Pre-intervention comfort counseling on genital gender-affirming surgery differed by residency region (p = 0.04), with residents in the West demonstrating the most comfort. Residents in the Midwest, Northeast, and South demonstrated increased comfort with counseling after the module (p < 0.01, p < 0.01, p = 0.01 respectively), while no change was observed in the West (p > 0.99). Residents in all regions had increased comfort with preoperative requirements for genital gender-affirming surgery after the module (p < 0.01, p < 0.01, p = 0.04, p = 0.03). A majority (81.9%) of residents felt that incorporation of this module would be beneficial to their OB/GYN training (99%). Conclusion: OB/GYN resident competence with counseling on genital gender-affirming surgery for transmasculine and nonbinary patients improved in the Midwest, Northeast, and South following a five-part clinical scenario-based educational module. Absence of a change in comfort counseling in the West suggest a decreased utility in this region.