A recent survey of active emergency physicians found that while most reported caring for transgender and gender-nonconforming patients in the emergency department, most respondents lacked basic clinical knowledge about caring for this population.
The study, published in the Annals of Emergency Medicine, included 399 respondents and found that 82.5% of those physicians had no formal training in the care of transgender and gender-nonconforming patients. Makini Chisolm-Straker, MD, MPH, of the Mount Sinai Brooklyn Department of Emergency Medicine, and colleagues found that although 86% of physicians felt comfortable asking about personal pronouns, only 26.1% knew the most common gender-affirming surgery for female-to-male patients, and only 9.8% knew the most common non-hormone gender-affirming medication that male-to-female patients take. Less than 3% were aware of emergency medicine practitioners performing inappropriate examinations on transgender and gender-nonconforming patients.
Transgender and gender-nonconforming individuals have difficulty accessing high-quality emergency care, and they may experience bias and inappropriate treatment in the emergency department. However, 59.9% of survey respondents did not support the use of “physician champions,” or physicians who promote practice changes, to improve emergency department care for these patients.
The authors note that further exploration is needed to determine why these physicians did not see the need for champions. They added that given the poor training that most emergency physicians have received in this area, it may be difficult to use physician champions to improve care.
Data from this study suggest that more research is needed regarding emergency department care of transgender and gender-nonconforming patients and indicate a need for better training of emergency department physicians on the components of medical care specific to this population.
Chisolm-Straker M, Willging C, Daul AD, et al. Transgender and gender-nonconforming patients in the emergency department: what physicians know, think, and do [published online November 3, 2017]. Ann Emerg Med. doi:10.1016/j.annemergmed.2017.09.042