Exposure to and Attitudes Regarding Transgender Education Among Urology Residents

J Sex Med. 2016 Oct;13(10):1466-72. doi: 10.1016/j.jsxm.2016.07.017. Epub 2016 Aug 27.


Introduction: Transgender individuals are underserved within the health care system but might increasingly seek urologic care as insurers expand coverage for medical and surgical gender transition.

Aim: To evaluate urology residents' exposure to transgender patient care and their perceived importance of transgender surgical education.

Methods: Urology residents from a representative sample of U.S. training programs were asked to complete a cross-sectional survey from January through March 2016.

Main outcome measures: Respondents were queried regarding demographics, transgender curricular exposure (didactic vs clinical), and perceived importance of training opportunities in transgender patient care.

Results: In total, 289 urology residents completed the survey (72% response rate). Fifty-four percent of residents reported exposure to transgender patient care, with more residents from Western (74%) and North Central (72%) sections reporting exposure (P ≤ .01). Exposure occurred more frequently through direct patient interaction rather than through didactic education (psychiatric, 23% vs 7%, P < .001; medical, 17% vs 6%, P < .001; surgical, 33% vs 11%, P < .001). Female residents placed greater importance on gender-confirming surgical training than did their male colleagues (91% vs 70%, P < .001). Compared with Western section residents (88%), those from South Central (60%, P = .002), Southeastern (63%, P = .002), and Mid-Atlantic (63%, P = .003) sections less frequently viewed transgender-related surgical training as important. Most residents (77%) stated transgender-related surgical training should be offered in fellowships.

Conclusion: Urology resident exposure to transgender patient care is regionally dependent. Perceived importance of gender-confirming surgical training varies by sex and geography. A gap exists between the direct transgender patient care urology residencies provide and the didactic transgender education they receive.

Keywords: Curriculum; Medical Education; Residency; Transgender Persons.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Internship and Residency / standards*
  • Male
  • Physician-Patient Relations
  • Transgender Persons*
  • Transsexualism*
  • Urology / education