"Just Like Any Other Patient": Transgender Stigma among Physicians in Puerto Rico

Area of Science:

• Health Disparities
• Medical Education
• Social Determinants of Health

Background:

• Transgender women (TW) in Puerto Rico (PR) experience significant social stigmatization.
• Physicians' stigma towards transgender individuals can negatively impact TW's health outcomes.
• Understanding these dynamics is crucial for improving healthcare access and quality for TW.

Purpose of the Study:

• To assess physicians' knowledge, competencies, and attitudes regarding transgender women in Puerto Rico.
• To investigate the relationship between physicians' characteristics and their level of stigma towards TW.
• To identify factors influencing the provision of healthcare services to TW.

Main Methods:

• An exploratory sequential mixed-methods design was employed.
• Data collection included in-depth interviews (n=30) and self-administered questionnaires (n=255).
• Qualitative and quantitative analyses were integrated to provide comprehensive findings.

Main Results:

• Qualitative findings revealed a lack of recognition of TW's specific health needs and the influence of stigmatizing attitudes on clinical decisions.
• Quantitative results indicated that increased willingness and knowledge to serve TW were associated with lower levels of stigma.
• Physicians with prior training in working with TW demonstrated significantly less stigma compared to those without training.

Conclusions:

• Specialized training is essential for healthcare providers in PR to deliver stigma-free services to transgender women.
• Addressing physicians' knowledge gaps and attitudes is critical for improving health equity for TW.
• Implementing targeted educational interventions can reduce stigma and enhance the quality of care for the transgender population.