Assessing Medical Students’ Self-Perceived Preparedness to Care for Gender Diverse Patients: A Survey Study

Background: Many transgender patients report avoiding healthcare due to discrimination, lack of provider knowledge, and perceived lower quality of care related to their gender identity. One factor contributing to these disparities may be a lack of preparation in medical school related to gender diversity. Methods: This cross-sectional survey study assessed third- and fourth-year medical students’ self-perceived preparedness to provide medical care for gender diverse patients, at one medical school in the United States. Mixed methods were used with both quantitative analyses and qualitative analyses using grounded theory. Results: 54 of 216 eligible students completed the survey (response rate 25%). 53.7% rated themselves as prepared to take a complete medical history from transgender patients compared to 94.4% for cisgender patients. 51.9% rated themselves as prepared to discuss cervical cancer screening with transmasculine patients. Only 31.5% rated themselves as prepared to provide inclusive preconception counselling. Concerns included using the wrong language and lacking appropriate medical knowledge. The most cited sources of learning about gender diversity were independent learning and fellow students. Five themes emerged in qualitative analyses, two of which included a request for greater opportunities to practice working with gender diverse patients and longitudinal integration of transgender medicine across the curriculum. Conclusion: Medical students who completed this survey rated themselves as less prepared to care for gender diverse patients compared to cisgender patients. Their current knowledge was largely based on learning outside of the medical school curriculum. The respondents highlighted many opportunities for improvement in medical school curricula.