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Transgender respondents who believe their clinician has lower knowledge about transgender care report higher psychological distress.

There is an association between perceived clinician knowledge about transgender people and self-rated health and psychological distress among transgender people, according to a study published online May 25 in JAMA Network Open.

Gabe H. Miller, Ph.D., from University of Alabama at Birmingham, and colleagues assessed whether patients’ perceived level of clinician knowledge about transgender care is associated with the self-rated health of transgender people. Analysis included 27,715 responses from participants in the 2015 U.S. Transgender Survey.

The researchers found that 24.6 percent of respondents reported their clinician knows almost everything about transgender care, while 11.5 percent reported their clinician knows almost nothing. Nearly one in four transgender adults (23.8 percent) reported having to teach their clinician about transgender people. Compared to individuals who reported their clinician knows almost everything about transgender care, exposure to clinicians with lower perceived levels of knowledge about transgender care was associated with significantly higher odds of fair or poor self-rated health among respondents (adjusted odds ratio [aOR] for knowing almost nothing, 2.63) and severe psychological distress (aOR for knowing almost nothing, 2.33). Similarly, respondents who had to teach a clinician about transgender people had higher odds of reporting fair or poor self-rated health (aOR, 1.67) and severe psychological distress (aOR, 1.49) versus those who did not.

“These results highlight the importance of integration and enhancement of transgender health in medical education curriculum as a necessary intervention to improve the health of transgender people,” the authors write.

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