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Despite significant strides in public awareness and legal protections for LGBTQI+ individuals, sexual and gender minorities continue to experience substantial health disparities. Among gender non-conforming individuals, one of the most prominent barriers to health care is the lack of access to knowledgeable and supportive health care providers.1

Several studies underscore that education on transgender health can markedly improve health care providers' knowledge, attitudes, preparedness, and comfort levels in caring for transgender patients. However, experts in gender-affirming care have highlighted a critical gap: the absence of a widely accessible, pediatric endocrine-based curriculum that addresses gender-affirming care alongside ethical considerations.1 

Maria Eleni Nikita, MD, a pediatric endocrinologist with the University of Maryland Medical Center, joined other members of the Pediatric Endocrine Society (PES) that have a special interest in transgender health to design a curriculum to expand the knowledge of gender affirming care for medical trainees' and faculty. As a result, Caring for Gender Diverse Youth (CFGDY) is a self-guided educational series comprised of five modules, largely based on the 2017 Endocrine Society Clinical Practice Guideline (Hembree et al., 2017).1,2

  • Module 1: Terminology, Creating an Environment of Inclusion, Caring for Non-Binary Youth, Ethical Principles
  • Module 2: Non-medical and Medical Management of the Pre-Pubertal/Early Pubertal Gender Diverse Child
  • Module 3: Medical Management of the Pubertal Gender Diverse Adolescent
  • Module 4: Surgical Options
  • Module 5: Psychosocial Considerations

Importance of a Gender-Affirming Curriculum

Creating and disseminating a pediatric endocrine-based curriculum that reviews gender-affirming care for gender-diverse youth is paramount for several reasons.

Competent and Compassionate Care

Such a curriculum equips trainees across various institutions with the knowledge and skills to provide competent and compassionate care to transgender and gender-diverse youth. Historically, medical education has often lacked comprehensive coverage of transgender health care, leaving health care providers underprepared to meet the needs of transgender patients.

Expanded Access to Care

Adequate training in transgender health care can expand access to competent health care for gender-diverse youth. As more health care providers become knowledgeable in this field, the barriers to care decrease, increasing the likelihood that transgender patients receive timely and appropriate treatment.

Inclusive Health Care Environment

A curriculum focused on gender-affirming care promotes awareness, sensitivity, and respect for diverse gender identities. This fosters a more inclusive and affirming health care environment for all patients, enhancing the overall quality of care.

Key Takeaways from the Study

From our recently published study in Endocrine and Metabolic Science, several critical points emerge that we hope other physicians will find valuable:1

  • Effective Self-Guided Learning: A self-guided online medical education curriculum on gender-affirming care effectively increases knowledge about best practice guidelines for transgender care.
  • Ethical Considerations: This is the first online educational module for gender-affirming care that uniquely incorporates ethical considerations, offering a holistic approach to training.
  • Educational Adjunct Tool: These education modules, which can be done in an asynchronous manner, can also be a supplementary tool for residents and medical students working with gender-diverse youth, enhancing their training experience.

Impact on Practice

This study's outcomes have influenced how we, and others at the University of Maryland Medical Center, approach medicine. We are integrating this crucial aspect of health care into their training by ensuring that medical students, residents, fellows, and faculty members have access to structured education on gender-affirming care. This initiative promises to cultivate a generation of health care providers who are knowledgeable and skilled in providing inclusive care to all patients and acutely aware of the unique needs and challenges faced by gender-diverse individuals across various specialties.

Developing and implementing a comprehensive, ethically integrated curriculum on gender-affirming care is a vital step toward bridging the knowledge gap in transgender medicine. By doing so, we hope to enhance the quality of care for gender-diverse youth and foster a more inclusive health care environment.

The Transgender Health program at the University of Maryland Medical Center is at the forefront of providing comprehensive support for children, adolescents, and their families as they navigate the journey of gender-affirming care. Under the expert guidance of Dr. Nikita, our program is committed to delivering compassionate, evidence-based, and affirming health care services. We understand the unique needs and challenges faced by gender-diverse youth and their families, and our dedicated team is equipped to provide guidance, support, and medical treatment options tailored to each individual's journey. 

Call for more information 410-328-8336

References

  1. Sandberg ES, Baines HK, Aye T, et al. A self-guided curriculum on endocrinology standard of care for gender diverse youth, including ethical considerations. Endocr Metab Sci. 2023;11:100131.
  2. Hembree WC, Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102(11):3869-3903. 

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