Experiences of Transgender and Gender Nonbinary Medical Students and Physicians.

Oscar E Dimant,Asa E Radix,Tiffany E Cook,Richard E Greene

doi:10.1089/trgh.2019.0021

Abstract

Purpose: To explore the experiences of transgender and gender nonbinary (TGNB) medical students and physicians in the United States.Methods: The authors conducted a 79-item online survey using Likert-type and open-ended questions to assess the experiences of TGNB-identified U.S. medical students and physicians. Variables included demographic data, disclosure of TGNB status, exposure to transphobia, and descriptions of educational and professional experiences. Recruitment was conducted using snowball sampling through Lesbian, Gay, Bisexual, Transgender, Queer professional groups, list-servs, and social media. The survey was open from June 2017 through November 2017.Results: Respondents included 21 students and 15 physicians (10 transgender women, 10 transgender men, and 16 nonbinary participants). Half (50%; 18) of the participants and 60% (9) of physicians had not disclosed their TGNB identity to their medical school or residency program, respectively. Respondents faced barriers on the basis of gender identity/expression when applying to medical school (22%; 11) and residency (43%; 6). More than three-quarters (78%; 28) of participants censored speech and/or mannerisms half of the time or more at work/school to avoid unintentional disclosure of their TGNB status. More than two-thirds (69%; 25) heard derogatory comments about TGNB individuals at medical school, in residency, or in practice, while 33% (12) witnessed discriminatory care of a TGNB patient.Conclusion: TGNB medical students and physicians faced significant barriers during medical training, including having to hide their identities and witnessing anti-TGNB stigma and discrimination. This study, the first to exclusively assess experiences of TGNB medical students and physicians, reveals that significant disparities still exist on the basis of gender identity.

Highlights

Transgender and gender nonbinary (TGNB) people have few protections across the United States, and 30% of respondents in the U.S Transgender Survey reported being fired or denied a promotion related to being TGNB.[1]
The objective of this study was to investigate the experience of TGNB medical students and physicians
We utilized the Nebraska Outness Scale modified for TGNB individuals, and we asked for descriptions of subjective experiences related to being a TGNB medical student and/or physician and possible incidents of discrimination or harassment

Summary

Introduction

Transgender and gender nonbinary (TGNB) people have few protections across the United States, and 30% of respondents in the U.S Transgender Survey reported being fired or denied a promotion related to being TGNB.[1] Approximately 1 million U.S adults (0.4%)[2] and 1.8% of adolescents[3] identify as TGNB, and in 2018, 0.7% of matriculating medical students identified as TGNB.[4]. We know little about TGNB medical professionals’ experiences. In a 2011 study of 427 LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer) physicians (1% transgender), physicians reported discrimination, harassment, social rejection, and witnessing discrimination against patients and colleagues, with 65% hearing colleagues disparage LGBTQ patients and 34% witnessing substandard care or denial of care to LGBTQ patients.[5] In a large 2014 study of medical students, lesbian, gay, and bisexual respondents indicated higher levels of depression, lower levels of perceived social support, and more discomfort a Oscar E.

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