Two Johnson & Wales PA program faculty (Thomas Meehan, PhD, PA-C and Aleko Kimbouris, MPH, PA-C) and a former student (Cameron Adelman, PA-C) presented this content at the recent PA Education Association Forum in Washington, D.C. The following are excerpts from the presentation.
Transgender people face numerous barriers in accessing competent healthcare and fewer than half of PA programs teach students about transgender clinical care. PAs working in all specialties will encounter transgender patients and it is vital for students to be educated about transgender health to reduce poor health outcomes for transgender patients.
According to Mahowald et al (2020), 18% of transgender (TG) patients were refused care for being TG and 33% had to teach their provider about TG people to get appropriate care. A study by McPhail et al (2016) demonstrated that many primary care providers (PCPs) are reluctant to prescribe gender-affirming hormone therapy (GAHT), due to a lack of education on TG healthcare and/or lack of experience prescribing GAHT. Pathoulas, et. al. (2021) conducted a study on improving medical student familiarity with providing GAHT via an optional one-hour lecture on GAHT which students were surveyed before and after. They found a statistically significant increase in medical student comfort and familiarity with GAHT after the focused lecture. Finally, in Rolls et al (2020), a survey of PA programs demonstrated that while 85.6% of programs had at least 1 hour of TG curriculum, only 40.3% included content on GAHT. PA programs that teach TG curriculum have largely focused on social tolerance while few cover topics related to clinical care.
While a student in the JWU PA program, Cameron Adelman, PA-C, helped PA faculty members identify areas in the curriculum that transgender health content could be integrated. The educational intervention developed was evidence-based and aims to go beyond what other institutions have done in transgender health education. This transgender clinical medicine curriculum was developed as a blueprint for implementation at PA programs that lack their own transgender health curriculum. A survey to assess the efficacy of the curriculum at improving student knowledge with transgender health topics demonstrated a statistically significant increase across all measured items. Additionally, the students preferred the integrated curriculum over a one-day approach.
The details of the blueprint were provided to attendees with resources available to any PA program that wants to include enhanced transgender content into their curriculum.
References
Rolls J, Davis J, Backman R, Wood T, Honda T. Curricular approaches to transgender health in physician assistant education. Academic Medicine. 2020;95(10):1563-1569. doi:10.1097/acm.0000000000003464
Mahowald L, Gruberg S, Halpin J. The state of the LGBTQ community in 2020. Center for American Progress. https://www.americanprogress.org/article/state-lgbtq-community-2020/. Published October 6, 2020. Accessed December 29, 2022.
McPhail D, Rountree-James M, Whetter I. Addressing gaps in physician knowledge regarding transgender health and healthcare through medical education. Can Med Educ J. 2016;7(2):e70-e78. Published 2016 Oct 18.
Pathoulas JT, Blume K, Penny J, Mansh M, Rubin N, Farah RS. Effectiveness of an Educational Intervention to Improve Medical Student Comfort and Familiarity With Providing Gender-Affirming Hormone Therapy. Fam Med. 2021;53(1):61-64. doi:10.22454/FamMed.2021.612374
Thomas Meehan, PhD, PA-C
RIAPA Board Member
