Transgender Patient Care in Urology: Evaluation of Attitudes, Knowledge and Practice Patterns among Urologists in the New York Metropolitan Area

Introduction: Transgender individuals suffer from significant health disparities, due in part to deficiencies in physician knowledge or comfort with addressing transgender health care needs. In this study we assessed the attitudes and clinical knowledge in caring for transgender patients of a representative sample of urologists in the New York metropolitan area. Methods: An anonymous, online based questionnaire was sent to members of the New York Section of the American Urological Association. Statements evaluating knowledge and attitudes toward transgender care were scored on a 5-point Likert scale. Results: A total of 92 providers (83.7% male) participated in the study, of whom 78.3% (72) have been in practice for at least 15 years. With respect to physician attitudes, there was a trend toward greater comfort with discussion of gender identity and counseling on gender confirmation surgery based on total number of transgender patients cared for during the course of their career. Regarding knowledge scores there were no significant associations with physician age, gender or years of practice. Despite the relatively weak self-reported fund of knowledge (2.64) and overall clinical competence (2.09), there was no overwhelming support to incorporate transgender care into urology training curricula (3.11). Conclusions: Despite growing education and awareness of transgender specific medical issues, many urologists self-report deficiencies in requisite knowledge and comfort in providing adequate, culturally competent care for transgender patients. Further work is needed to increase our collective comfort level with this new and evolving aspect of our field.