Doctors Are Treating Trans People Without Training

A study shows most endocrinologists specializing in hormone health are poorly prepared to care for transgender patients

Photo Illustration: Diana Quach
Jan 10, 2017 at 2:01 PM ET

Endocrinologists can be a vital resource for transgender people, particularly if they use hormone replacement therapy to transition. But, according to a new study, four out of five of these physicians specializing in hormone health have never received formal training on providing care to transgender patients.

“As awareness and insurance coverage of transgender healthcare has increased, there is growing demand for healthcare providers with expertise in this area,” said study author Caroline Davidge-Pitts of the Mayo Clinic in a press release. “It is crucial for endocrinologists to receive the necessary training to feel confident providing the highest quality care for this population.”

Researchers from the Mayo Clinic and the Endocrine Society surveyed 411 U.S. endocrinologists about issues around treating transgender patients. They found that 81 percent had never received formal training in that area. Despite that, nearly 80 percent had treated a transgender person in their career, and most were comfortable with taking patient histories and prescribing hormones to transgender patients.

This builds on a smaller scale survey last year finding that nearly 60 percent of endocrinologists said they felt more comfortable with cisgender patients than transgender patients, and a third altogether refused to see transgender patients. In 2015, a survey of U.S. and Canadian medical students found that the majority thought their training in LGBT health was “fair” at best. It’s no surprise, then, that a Lambda Legal survey found that 70 percent of transgender or gender-nonconforming people have experienced maltreatment from medical providers.

The researchers behind the current study also surveyed 54 directors of training programs for future endocrinologists and, on a more positive note, found that 35 — or 72 percent — provided formal training on transgender health. That still falls short of the 94 percent of surveyed program directors who said that training in this area is important. The main barrier to providing this education was “lack of faculty interest or experience,” according to the study.

“The survey results will help us develop strategies to educate endocrinologists who are currently in practice as well as those entering the field about transgender care,” Davidge-Pitts said. “Teaching transgender health topics earlier, in medical school or residency, is one way to ensure young professionals are prepared.”