Objeción de conciencia a la atención de afirmación de género en residencias pediátricas de EE. UU

This study aims to characterize physician objections to the provision of gender-affirming care within accredited U.S. pediatric residencies and to explore the relevance of institutional conscientious objection policies.

A cross-sectional electronic survey was distributed by the Association of Pediatric Program Directors to pediatric residency program leadership representatives from September-October 2023. Responses were compared using descriptive statistics and bivariate/multivariate analyses (P<0.05).

In total, 84 of 182 (46%) pediatric residencies completed the survey. Most programs engaged in formal didactic training (n=66, 79%) and direct clinical exposure (n=57, 68%) to gender-affirming care, yet few programs (n=7, 8%) endorsed having institutional objection policies. Four programs (5%) reported trainee (n=3, 75%) or faculty (n=1, 25%) objections to gender-affirming care, none of which had formal objection policies in place. Leadership at programs with objection policies (n=7, 8%) reported increased confidence in addressing future objections, as compared to those without (p<0.01).

Objections to gender-affirming interventions are a rare, but plausible within pediatric residency programs, thus programs should consider anticipatory policies that balance trainee beliefs, required competency training, and safe, equitable patient care.