Gender-Affirming Care of Transgender Patients in Primary Care: An Asynchronous, Online Case-Based Curriculum for...

Transgender and gender-diverse (TGD) individuals represent a growing demographic in the United States. This population, however, faces many health inequities, in part attributable to a lack of education for physicians in training on transgender health care at both the graduate and undergraduate medical education levels. We developed a curriculum on gender-affirming care for Internal Medicine (IM) residents to fill this educational gap.

We created a virtual, asynchronous, case-based curriculum on gender-affirming care for IM residents at a large urban academic medical center. To address gaps in prior curricula, we included attitudinal, knowledge, and skills-based material and assessments. We used precurriculum, immediate postcurriculum, and delayed 1-month postcurriculum surveys to assess curriculum efficacy, learner satisfaction, and knowledge retention.

We found that 77.8% of IM resident participants had cared for a TGD patient but had received little prior training in gender-affirming care, and residents reported low levels of confidence in caring for this patient population. After completing the curriculum, performance on knowledge-based questions improved significantly, and residents reported significantly higher confidence in providing gender-affirming care. These improvements were durable on the delayed posttest.

A virtual, asynchronous, case-based curriculum on gender-affirming care in a primary care setting was effective at increasing residents' knowledge and confidence in transgender health, a topic that learners believed was important to their practice. These benefits persisted at 1 month, demonstrating knowledge retention. These findings support the importance of expanding education on gender-affirming care for TGD individuals, and interleaving material over time to promote retention.