Facial Plast Surg
DOI: 10.1055/a-2295-6582
Original Research

Perceptions and Understanding of Transgender Patient Care: A Survey of Practicing Facial Plastic Surgeons

Megan L. Swonke
1   Department of Otolaryngology—Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas
,
Anthony E. Brissett
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
,
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
,
Joshua J. Kain
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
,
Fred J. Bressler
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
,
Amina I. Malik
3   Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
,
Tariq A. Syed
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
,
Angela K. Sturm
2   Department of Otolaryngology—Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
4   Dr. Angela Sturm, 6750 West Loop Street, Bellaire, Texas
› Author Affiliations

Abstract

Transgender individuals face significant health disparities including deficiencies in physician education, knowledge, and comfort with care. The objective of this study was to determine the perceptions, practice patterns, and familiarity of facial plastic surgeons with transgender health care. An anonymous questionnaire was sent to facial plastic surgeons within the American Academy of Facial Plastic and Reconstructive Surgery list-serve. Primary datapoints included participant characteristics, transgender-related experience, and educational goals. Of the 66 facial plastic surgeons surveyed, 49% had treated 1 to 10 transgender patients during their career, and 70% were actively treating at least 1 transgender patient. The number of patients treated and surgeries performed was significantly associated with self-perceived competence, comfort counseling on gender-affirming surgeries, discussing gender identity, asking preferred pronouns, and a desire to learn more about transgender care. Most participants (61%) obtained transgender care training through real-world experience, with only 18% receiving formal training in residency or fellowship. In total, 50% of respondents believe transgender care training among facial plastic surgeons is inadequate and 60% support its incorporation into residency/fellowship curricula. Increased awareness is needed to address the disparities experienced by transgender patients. Many facial plastic surgeons desire to learn more and support incorporating transgender care into training. Understanding the current state of transgender care can assist the facial plastic community in promoting education that strengthens physicians' ability to deliver competent care that addresses the inequities faced by this diverse group.

Previous Presentation

This article was presented at the American Academy of Facial Plastic and Reconstructive Surgery: Advances in Rhinoplasty & Facial Rejuvenation, San Diego, California, May 28th, 2023.


Supplementary Material



Publication History

Accepted Manuscript online:
27 March 2024

Article published online:
30 April 2024

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  • References

  • 1 Flores AR, Brown TNT, Herman JL. Race and ethnicity of adults who identify as transgender in the United States. UCLA: The Williams Institute. Accessed April 03, 2024 at: https://escholarship.org/uc/item/69j3q4n0 2016
  • 2 James SE, Herman JL, Rankin S, Keisling M, Mottet L, Anafi M. The Report of the 2015 U.S. Transgender Survey. Washington, DC:: National Center for Transgender Equality.; 2016
  • 3 Shires DA, Stroumsa D, Jaffee KD, Woodford MR. Primary care clinicians' willingness to care for transgender patients. Ann Fam Med 2018; 16 (06) 555-558
  • 4 Sanchez NF, Sanchez JP, Danoff A. Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City. Am J Public Health 2009; 99 (04) 713-719
  • 5 Massenburg BB, Morrison SD, Rashidi V. et al; Transgender Educational Study Group. Educational exposure to transgender patient care in otolaryngology training. J Craniofac Surg 2018; 29 (05) 1252-1257
  • 6 Winoker JS, Kent MA, Omidele OO, Grotas AB. Transgender patient care in urology: evaluation of attitudes, knowledge and practice patterns among urologists in the New York Metropolitan Area. Urol Pract 2019; 6 (03) 174-179
  • 7 Sterling J, Garcia MM. Cancer screening in the transgender population: a review of current guidelines, best practices, and a proposed care model. Transl Androl Urol 2020; 9 (06) 2771-2785
  • 8 Ensslin CJ, Khanijow K, Yenokyan G, Loss M. A cross-sectional survey of knowledge, attitudes, and practice in the prescription of isotretinoin for transgender patients among academic dermatologists. J Am Acad Dermatol 2019; 81 (06) 1426-1429
  • 9 Safer JD, Coleman E, Feldman J. et al. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes 2016; 23 (02) 168-171
  • 10 Unger CA. Care of the transgender patient: a survey of gynecologists' current knowledge and practice. J Womens Health (Larchmt) 2015; 24 (02) 114-118
  • 11 Irwig MS. Transgender care by endocrinologists in the United States. Endocr Pract 2016; 22 (07) 832-836
  • 12 Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students' ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med 2006; 38 (01) 21-27
  • 13 Kelley L, Chou CL, Dibble SL, Robertson PA. A critical intervention in lesbian, gay, bisexual, and transgender health: knowledge and attitude outcomes among second-year medical students. Teach Learn Med 2008; 20 (03) 248-253
  • 14 Obedin-Maliver J, Goldsmith ES, Stewart L. et al. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA 2011; 306 (09) 971-977
  • 15 Nolan IT, Blasdel G, Dubin SN, Goetz LG, Greene RE, Morrison SD. Current state of transgender medical education in the United States and Canada: update to a scoping review. J Med Educ Curric Dev 2020; 7: 2382120520934813