Gender-Affirming Care Curriculum in Family Medicine Residencies: A CERA Study

BACKGROUND AND OBJECTIVES: Family physicians are positioned to provide care for transgender patients, but few are trained in this care during residency. This study examines associations between program directors' (PDs) perceptions/beliefs on transgender health care and inclusion of gender-affirming health care (GAH) in residency curriculum. METHODS: Questions regarding current training in GAH, provision of GAH, competency in GAH delivery, barriers to GAH training, resident desire for GAH training, access to GAH curriculum, and feelings/perceptions about GAH were included in the 2020 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey. RESULTS: Challenges to including GAH in residency curriculum were inadequate numbers of transgender patients for residents to provide care (35.4%) and lack of faculty expertise in GAH for transgender patients (24.6%). PDs were more likely to include GAH into curriculum when they provided care for transgender patients in their own practice, completed continuing medical education in GAH since completing residency, had confidence in teaching GAH to residents, had residents who requested training on GAH, or had access to a GAH curriculum. PDs who believed that GAH should be a core competency in residency curriculum were more likely to have residents who requested increased education in GAH and wanted to provide GAH to transgender patients in their future practices. CONCLUSIONS: Barriers persist for training family medicine residents in GAH for transgender patients, but further training opportunities for faculty could help to decrease identified barriers. Further research should explore how best to increase family medicine faculty comfort/competence in educating residents in GAH.