Transgender patients: Prejudice and training needs among trainees in 6 U.S. Emergency Medicine residency programs

INTRODUCTION: Transgender (trans) individuals experience significant health disparities due to stigma and discrimination in healthcare settings. Consequently, they often avoid Emergency Departments (ED) and delay seeking care. Studies examining attitudes and preparedness of ED providers regarding trans healthcare are lacking.

OBJECTIVES: This pilot study aimed to measure transphobia and preparedness treating trans patients among Emergency Medicine (EM) residents.

METHODS: In 2012, directors of 6 U.S. EM training programs forwarded an anonymous 42-item questionnaire to all trainees that included the Transphobia Scale and Likert-type questions regarding comfort, preparedness, experience, and training needs related to trans patients. Programs were selected by convenience sampling.

RESULTS: Eighty-four of 333 eligible trainees responded (26% response rate). We found a mean transphobia score of 2.8 (SD=0.9) corresponding to relatively mild levels of transphobia. The majority (89.4%) reported that they felt comfortable treating trans patients and working with trans colleagues (88.3%). While 65.9% had knowingly treated trans persons during residency, only 55.7% felt well prepared, 62.3% felt they needed more training and 78.8% did not know where to access reliable trans-specific health literature.

CONCLUSIONS: Comparing transphobia levels of our sample to those published for other groups, we found that on average, they had less prejudice towards trans persons than university psychology students, but more than social work students. While most felt comfortable treating trans patients, ED residents felt their training was inadequate. Further research is needed to examine how to improve trans-specific medical training for emergency physicians and how this affects ED utilization by trans persons.