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Hormone specialists want more education about transgender patients

Doctors who specialize in conditions in which hormones need more training how to deal with people who are transgender are, suggests a new study.

The researchers found that transgender health is a part of the curriculum in less than three quarters of the endocrinology training programs that responded to an online survey.

In addition, more than 80 percent of the practicing specialists said that they had a training on transgender medicine.

“We were aware that a shortage in education probably existed, but it was surprising how large this shortage is among general practitioners in the practice,” wrote lead author Dr. Caroline Davidge-Pitts, of the Mayo Clinic in Rochester, Minnesota.

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Gender identity is how people see themselves, that is, as a man, a woman, or something less specific. People who are transgender are gender identities that differ from the gender assigned at birth.

While the awareness and acceptance of transgender issues has increased in the last ten years is to provide optimal care for patients is still a challenge, the researchers write in The Journal of Clinical Endocrinology and Metabolism.

Endocrinologists often have an important role in the care. They specialize in the endocrine system, which regulates the body’s hormones, and they can prescribe sex hormones such as testosterone and estrogen, to help transgender patients develop the physical characteristics tied to their gender identity.

Information is missing about how many doctors in the endocrinology training will be taught about transgender care. There is also not much information about the training of physicians already in practice.

For the new study, the researchers sent a web-based survey of the directors of 104 endocrinology training programs and received an answer back from 54. About 94 percent said education about transgender care is important, but only about 72 percent included the topic in their curricula.

All programs, covered the principles of hormone therapy for transsexual patients, but only about 63 percent taught the students to take broad social and sexual history of these patients. Also, only 40 percent taught students how to conduct physical exams on transgender patients.

“Endocrinology fellowships will continue to face challenges with adding transgender health topics on the program and we need to be proactive about finding ways to improve it,” Davidge-Pitts told Reuters Health.

The research team sent surveys to nearly 7,000 doctors who were members of the Endocrine Society, but only a very small percentage – 411 medical doctors responded. About 80 percent said that they had treated transgender patients at some point during their career, but a similar proportion said that they never trained in the specific features of that specialized care.

The majority of the doctors reported confidence in the use of the correct terminology, taking of history and the provision of hormones, but few showed similar confidence to discuss psychosocial and legal issues, surgical procedures and screening guidelines.

“In my eyes, the remarkable thing is that they say ‘train me,'” said Dr. Joshua Safer, the medical director for Transgender Medicine and Surgery at the Boston University School of Medicine.

The researchers found that the directors of the training programs require online programs for students and teachers, lectures and wish to participate in the meetings that deal with transgender topics. Also practicing endocrinologists who responded to the survey wanted to online training sessions and presentations on transgender topics at scientific meetings.

Safer, who was not involved in the new research, is working to update the Endocrine Society’s 2009 guidelines on transgender care.

“The real take-home message is the clinical population feels still not prepared,” he told Reuters Health.

The new guidelines should go a long was to this gap, he added.

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