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Gendered Expectations: Strategies for Navigating Structural Challenges in Support of Transgender and Nonbinary
Tiffany E Cook1, Oscar E Dimant, Rebecca Novick
1T.E. Cook is program manager, Training and Professional Development, Office of Diversity Affairs, New York University Grossman School of Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-5362-4330. O.E. Dimant is resident physician, Internal Medicine, Northwell Health, Staten Island University Hospital, New York, New York; ORCID: http://orcid.org/0000-0001-9392-0890. R. Novick is senior program coordinator, Student Engagement and Transition Programs, Office of Student Affairs, New York University Grossman School of Medicine, New York, New York. A. Adegbola is former director, Office of Diversity Affairs, New York University Grossman School of Medicine, New York, New York. U. Blackstock is former associate professor, Emergency Medicine, and director, Recruitment, Retention, and Inclusion, Office of Diversity Affairs, New York University Grossman School of Medicine, New York, New York. C.B. Drake is resident physician, Internal Medicine, New York University Grossman School of Medicine, New York, New York. M.E. Patenaude is program coordinator, Recruitment and Retention, Office of Diversity Affairs, New York University Grossman School of Medicine, New York, New York. J.E. Ravenell is associate dean, Diversity and Inclusion, and associate professor, Population Health, New York University Grossman School of Medicine, New York, New York. A. Radix is senior director, Research and Education, Department of Medicine, Callen-Lorde Community Health Center, New York, New York, and clinical associate professor, Internal Medicine, New York University Grossman School of Medicine, New York, New York. R.E. Greene is associate professor, Internal Medicine, and director of health disparities education, Office of Diversity Affairs, New York University Grossman School of Medicine, New York, New York; ORCID: https://orcid.org/0000-0001-8618-7723.
Abstract:
Members of the lesbian, gay, bisexual, transgender, and queer community experience marginalization, bias, and discrimination, including in the world of academic medicine. People who are transgender and nonbinary (TGNB) experience further marginalization compared with individuals who are lesbian, gay, bisexual, and queer. According to a recent survey, more than half of medical students who are TGNB chose not to disclose their gender identities during training due to fears of discrimination, feeling a lack of support, and concerns about future career options. Academic medicine has historically pathologized TGNB individuals, perpetuating discrimination structurally and reinforcing discriminatory behaviors of peers and faculty. In this Perspective, the authors provide a comprehensive overview of the challenges that administrators and educators face in creating a learning environment that is inclusive of TGNB trainees. They outline opportunities for change and provide strategies to address administrative and educational challenges, including those related to institutional climate, policies, data collection, physical spaces, health care, curriculum, mentoring, and the evaluation of TGNB trainees. Finally, the authors issue a call to action for medical educators and administrators to create environments in which trainees who are TGNB can fulfill their educational mission: to learn the practice of medicine.
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