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Are Obstetrics and Gynecology Residents Equipped to Care for Transgender and Gender Nonconforming Patients? A National Survey Study.

Purpose: Our study aims to assess three self-reported outcomes: (1) comfort of, (2) competency in, and (3) curricular satisfaction of OB-GYN residents in caring for transgender and gender nonconforming (TGNC) patients. Methods: This was a cross-sectional survey of a convenience sample of OB-GYN residents consisting of 28 questions on a 4-point Likert scale. The survey was distributed to OB-GYN residents via residency program directors and coordinators. Descriptive statistics and multivariate linear regression modeling were performed to identify demographic and training characteristics associated with differences in comfort, competency, and curricular satisfaction. Results: One-hundred twenty-six surveys were completed by OB-GYN residents (response rate=12.6%). Composite mean scores were calculated in the three self-reported outcome domains: comfort (2.8±0.67), competency (2.7±0.61), and satisfaction (2.2±0.82) which correlate to being "somewhat not" and "somewhat" comfortable, competent, and satisfied. Trainees who identified as lesbian, gay, bisexual, or queer were found to have higher comfort scores. Older age and male gender identity were associated with higher competency scores. No significant differences in comfort, competency, and satisfaction scores between residency training level were observed. The majority (78.1%, N=89) of trainees "strongly agreed" that it was important for them to obtain training in TGNC care topics. Conclusion: OB-GYN residents strongly agreed that learning about care for TGNC patients was important. Residents reported being more competent and comfortable than satisfied, which suggests that further curricular and clinical exposure is necessary to address the unique health care needs of this underserved patient population and to meet the educational needs of OB-GYN residents.