Knowledge, Attitudes and Practices of East Tennessee Medical Providers towards Transgender Patients

One-third of transgender individuals report having at least one negative health care experience related to being transgender and nearly a quarter report that they have delayed seeking health care due to fear of being mistreated. Objective: To assess medical providers’ experiences with, attitudes towards, and knowledge of transgender health care in the Northeast Tennessee region. Study Design: Cross-sectional survey. Setting: Academic and community health care clinics in Northeast Tennessee. Participants: Physicians, nurse practitioners, and physician assistants practicing emergency medicine, family medicine, internal medicine, obstetrics & gynecology, or pediatrics (n=154). Main and Secondary Outcome Measures: Descriptive statistics and multiple regression models were used to determine relationships between provider characteristics and three sets of dependent variables (practices, attitudes, and knowledge). Results: The majority of providers (65%) had not received training in transgender healthcare. Over 90% perceived they had treated fewer than five trans-identified patients in the last year. The majority of respondents (69.3%) felt comfortable providing health care to transgender patients, yet only 38% felt competent treating this population. Providers indicated it was important to know their patients’ sexual practices, gender identity and sexual orientation; however, the majority of providers never or rarely asked patients their gender identity (75.4%), sexuality (57.2%), or desired pronouns (84.4%). Having formal training in transgender health was the only significant predictor of knowledge, sexual orientation and gender history taking, and competence/comfort with transgender patient care. Conclusions: Results demonstrate a contradiction between ideology and practice. Most participants responded they felt comfortable providing care to the transgender population, yet their responses indicated a lack of training and absence of inclusivity in their health care practices. As formal training was the only significant predictor of outcomes, this suggests that additional medical education and training is needed on transgender health care