Educational Exposure to Transgender Patient Care in Plastic Surgery Training.
BACKGROUND
Gender dysphoria is estimated to occur in up to 0.9 percent of the U.S.


METHODS
With increasing awareness and decreasing stigma surrounding transgender issues, it is predicted that more patients will begin to seek medical and surgical transition. This study aims to determine the current state of transgender-related education in U.S. plastic surgery residency programs and to evaluate trainee perceptions regarding the importance of such training.


METHODS
Plastic surgery trainees from a representative sample of 21 U.S. training programs were asked to complete a cross-sectional eight-question survey between November of 2015 and January of 2016. Respondents were queried regarding demographics, transgender curricular exposure (didactic versus clinical), and perceived importance of training opportunities in transgender patient care.


RESULTS
A total of 322 residents or fellows responded to the survey (80 percent response rate) from four U.S. Census regions. Sixty-four percent of respondents had education on or direct exposure to transgender patient care during residency. Among those with experiences in gender-confirming surgery, more than half were exposed to chest and genital surgery. Overall, the majority of respondents believed that training in gender-confirming surgery is important, and 72 percent endorsed the necessity for gender-confirming surgery fellowship training opportunities.


CONCLUSIONS
A significant number of plastic surgery trainees are exposed to transgender patient care, although exposure type is variable. The majority of trainees endorsed the importance of residency and fellowship training in gender-confirming surgery. To better serve the transgender population, formal fellowship training in gender-confirming surgery should be offered.
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Shane D
SD
Morrison
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
H Jonathan
HJ
Chong
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Geolani W
GW
Dy
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
David W
DW
Grant
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Stelios C
SC
Wilson
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Jonathan P
JP
Brower
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Nicholas B
NB
Vedder
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Jens U
JU
Berli
Seattle, Wash.; St. Louis, Mo.; New York, N.Y.; Providence, R.I.; and Portland, Ore.|From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Urology, University of Washington School of Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University of St. Louis School of Medicine; the Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
Jeffrey B
JB
Friedrich
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005257:Fellowships and Scholarships / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D062985:Health Services for Transgender Persons; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D057830:Gender-Affirming Surgery / Q000193:education*; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States