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 Nearly 90 percent of the doctors said they had not received enough
training to prescribe hormones to help patients prepare for a gender
transition.
The prevalence of gender dysphoria in the military "seems to come as
a surprise to people," said lead author Dr. Natasha Schvey, of the
Uniformed Services University of the Health Sciences in Bethesda,
Maryland.
Gender dysphoria is the stress and anxiety that results when a
person's gender identity and biological sex are not aligned.
Individuals who identify as transgender are overrepresented 2 to 1
in the military, compared to the civilian population, Schvey told
Reuters Health.
She and her colleagues write in JAMA Internal Medicine that the
Pentagon lifted its ban on transgender people serving openly in the
U.S. military in 2016. That came a few months after the meeting at
which the survey was conducted; since then, efforts have been made
to educate military healthcare providers about transgender care.
Military physicians care not just for active-duty service members
but for their family members as well.
The researchers write that about 13,000 people who are transgender
currently serve in the military and each year, about 200 will seek
treatment, such as hormones and surgery, for gender dysphoria.
In 2016, Schvey's team surveyed 204 family doctors attending the
annual meeting of the Uniformed Services Academy of Family
Physicians. Respondents were mostly white men working in academic
medical centers.
About 37 percent said they had treated a patient for gender
dysphoria at some point in their careers, but about 95 percent said
they received three hours or less of training on the topic during
their medical education. About 74 percent received no training.
About 76 percent of respondents felt they could provide transgender
patients with "nonjudgmental" care. About 51 percent also said that
being exposed to transgender patients would make them more
comfortable providing care to that population.
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Still, 51 percent of the respondents said they would not provide
hormones to treat gender dysphoria even if they received training.
The finding that over half of the doctors would refuse to provide
that service is difficult to interpret, however. It could be that
they would be more likely to provide care after additional training.
Training in transgender care was tied to the likelihood that doctors
would prescribe hormone therapy to eligible patients.
The military is now implementing training for doctors about
transgender healthcare, including computer-based programs, forums,
conferences and a new curriculum, said Schvey's co-author Dr. David
Klein, of the Fort Belvoir Community Hospital in Virginia and the
Uniformed Services University of the Health Sciences.
"It’s impressive the scale of the implementation of this training,"
he told Reuters Health.
"I think it shows the military is leading the way in this aspect,"
he said. "I’m not sure civilian physicians are receiving as much."
SOURCE: http://bit.ly/2nq4f8W and http://bit.ly/2nqctOo JAMA
Internal Medicine, online March 13, 2017.
(This version of the story was refiled to modify paras 1 and 6 to
clarify timing of the survey)
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