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Research ArticleResearch Briefs

Primary Care Clinicians’ Willingness to Care for Transgender Patients

Deirdre A. Shires, Daphna Stroumsa, Kim D. Jaffee and Michael R. Woodford
The Annals of Family Medicine November 2018, 16 (6) 555-558; DOI: https://doi.org/10.1370/afm.2298
Deirdre A. Shires
1School of Social Work, Michigan State University, East Lansing, Michigan
2Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan
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  • For correspondence: shiresde@msu.edu
Daphna Stroumsa
3Department of Obstetrics and Gynecology, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Kim D. Jaffee
4School of Social Work, Wayne State University, Detroit, Michigan
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Michael R. Woodford
5Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
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    Table 1

    Clinician Characteristics, Exposure to Transgender Individuals, Barriers and Facilitators Related to Caring for Transgender Patients, and Willingness to Provide Care (N = 140)

    Clinician characteristicsn (%)
    Age (mean, SD)39.7 (13.4)
    Sex
     Male58 (41.4)
     Female82 (58.6)
    Continent of origin
     North America/Caribbean91 (65.5)
     Other48 (34.5)
    Political views
     Liberal66 (47.1)
     Moderate51 (36.4)
     Conservative23 (16.4)
    Specialty
     Internal medicine97 (69.3)
     Family medicine43 (30.7)
    Clinician type
     Resident73 (52.1)
     Advanced practitioner3 (2.1)
     Attending physician64 (45.7)
    Exposure
    Ever met a transgender person
     Yes106 (75.7)
     No34 (24.3)
    Treated transgender patient in past 5 years
     Yes75 (53.6)
     No65 (46.4)
    Empathy (mean, SD)a5.4 (1.5)
    Transphobia (mean, SD)a3.2 (1.1)
    Barriers and Facilitators
    Lack of training on transgender healthb
     Yes67 (47.9)
     No73 (52.1)
    Lack of exposure to transgender patients
     Yes52 (37.1)
     No88 (62.9)
    Lack of knowledge about transgender care among staffb
     Yes45 (32.1)
     No95 (67.9)
    Lack of familiarity with transition care guidelinesb
     Yes73 (52.1)
     No67 (47.9)
    Capable of providing routine care to transgender patientsb
     Yes96 (68.6)
     No44 (31.4)
    Willingness to provide care
    Willing to provide routine care for transgender patientsb120 (85.7)
    Willing to provide Pap tests for transgender menb104 (78.6)
    • Pap = Papanicoulou.

    • ↵a Theoretical range 1–7. Higher score represents greater empathy or transphobia.

    • ↵b Originally measured on a 7-point scale. Dichotomized for analysis (1-4=no, 5-7=yes).

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    Table 2

    Factors Associated With Primary Care Clinicians’ Willingness to Provide Routine Care for Transgender Patients and Pap Tests for Transgender Men (N = 140)

    Routine Care for Transgender PatientsPap Test for Transgender Men
    No. (%)P ValueNo. (%)P Value
    Clinician characteristics
    Age (mean, SD).042.246
     Willing38.7 (13.2)39.0 (13.4)
     Not willing45.3 (13.5)42.2 (13.3)
    Sex.262.511
     Male89.775.9
     Female82.980.5
    Continent of origin.002.044
     North America/Caribbean92.383.5
     Other72.968.8
    Political views.379.101
     Liberal89.486.4
     Moderate80.472.5
     Conservative87.069.6
    Specialty.940.020
     Internal medicine85.673.2
     Family medicine86.090.7
    Clinician type.156.165
     Resident90.483.6
     Advanced practitioner100.0100.0
     Attending MD79.771.9
    Exposure
    Ever met a transgender person.020<.001
     Yes89.685.8
     No73.555.9
    Transgender patient in past 5 years.022.012
     Yes92.086.7
     No78.569.2
    Barriers & facilitators
    Empathy (mean, SD).035.083
    Willing5.5 (1.4)5.5 (1.3)
    Not willing4.8 (1.6)4.9 (1.8)
    Transphobia (mean, SD).007<.001
    Willing3.1 (1.0)3.0 (1.0)
    Not willing3.8 (1.3)3.8 (1.1)
    Lack of training on transgender health.240.006
     Yes82.168.7
     No89.087.7
    Lack of exposure to transgender patients.022.013
     Yes76.967.3
     No90.985.2
    Lack of knowledge about transgender.018.018
    care among staff
     Yes75.666.7
     No90.584.2
    Lack of familiarity with guidelines.782.027
     Yes84.971.2
     No86.686.6
    Capable of providing routine care<.001.043
     Yes99.083.3
     No56.868.2
    • Pap = Papanicoulou.

Additional Files

  • Tables
  • Supplemental Appendix

    Supplemental Appendix

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    • Supplemental data: Appendix - PDF file
  • The Article in Brief

    Primary Care Clinicians' Willingness to Care for Transgender Patients

    Deirdre A. Shires , and colleagues

    Background Transgender patients report negative experiences in health care settings, but little is known about clinicians' willingness to care for them. This study surveyed primary care clinicians in an integrated Midwest health system.

    What This Study Found Most, but not all, family medicine and general internal medicine clinicians are willing to provide routine care for transgender patients. The survey of 308 primary care clinicians found that 86 percent of respondents (n = 140) were willing to provide routine care to transgender patients and 79 percent were willing to provide Pap tests to transgender men. Willingness to provide routine care decreased with age. Willingness to provide Pap tests was higher among family physicians, those who had met a transgender person, and those who measured lower on a transphobia scale.

    Implications

    • These findings, according to the authors, underscore the importance of integrating personal exposure to transgender individuals into medical education.
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The Annals of Family Medicine: 16 (6)
The Annals of Family Medicine: 16 (6)
Vol. 16, Issue 6
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Primary Care Clinicians’ Willingness to Care for Transgender Patients
Deirdre A. Shires, Daphna Stroumsa, Kim D. Jaffee, Michael R. Woodford
The Annals of Family Medicine Nov 2018, 16 (6) 555-558; DOI: 10.1370/afm.2298

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Primary Care Clinicians’ Willingness to Care for Transgender Patients
Deirdre A. Shires, Daphna Stroumsa, Kim D. Jaffee, Michael R. Woodford
The Annals of Family Medicine Nov 2018, 16 (6) 555-558; DOI: 10.1370/afm.2298
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