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Background <p>Although gender-affirming hormone therapy (GAHT) can be safely prescribed in primary care settings, many primary care providers (PCPs) feel unprepared to do so for transgender and gender-diverse (trans) patients.</p> Objective <p>To evaluate and compare two brief educational interventions for changing attitudes, knowledge, and likelihood to prescribe GAHT for trans patients.</p> Design <p>Randomized controlled trial</p> Participants <p>Internal Medicine residents with a primary care clinic</p> Main Measures <p>Surveys measuring attitudes pertaining to care for trans patients (e.g., Transphobia scale, range of 1–7), 20-item knowledge assessment, six-item clinical self-assessment, and two-item self-reported likelihood to prescribe GAHT (1–7 scale).</p> Key Results <p>Of 1596 eligible residents, 623 (39.0%) were included in the analysis. Transphobia scores were low at baseline (mean = 2.09, SD = 0.90). Transphobia decreased in both the clinical and cultural arms from 2.07 to 1.78 (<i>p</i> &lt; 0.001) and from 2.11 to 1.81 (<i>p</i> &lt; 0.001), respectively. At baseline, residents had a higher likelihood to continue a patient’s GAHT prescription (mean = 5.26, SD = 1.68) than to start a patient on GAHT (mean = 3.55, SD = 1.71). After watching the webinars, both arms were statistically significantly more likely to continue GAHT (mean = 5.66, SD = 1.48) and start GAHT (mean = 4.29, SD = 1.73). Knowledge scores and comfort addressing health care needs of trans patients were greater in the clinical arm; there were no other differences in changes between the two randomized groups.</p> Conclusions <p>We found that brief educational videos had measurable effects on attitudes and likelihood to prescribe GAHT in IM resident PCPs. Addressing clinical knowledge gaps may be a more efficient way to achieve these results than focusing on cultural competency.</p>

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Randomized Trial of Education to Increase Resident Prescribing of Gender-Affirming Hormone Therapy

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Helene F. Hedian,
  • Aliza Norwood,
  • Jennifer Siegel,
  • Dani F. Loeb,
  • Christopher Terndrup,
  • Megan McNamara,
  • Carl G. Streed Jr,
  • Marielle Bugayong,
  • Amanda Bertram,
  • Sean Tackett

摘要

Background

Although gender-affirming hormone therapy (GAHT) can be safely prescribed in primary care settings, many primary care providers (PCPs) feel unprepared to do so for transgender and gender-diverse (trans) patients.

Objective

To evaluate and compare two brief educational interventions for changing attitudes, knowledge, and likelihood to prescribe GAHT for trans patients.

Design

Randomized controlled trial

Participants

Internal Medicine residents with a primary care clinic

Main Measures

Surveys measuring attitudes pertaining to care for trans patients (e.g., Transphobia scale, range of 1–7), 20-item knowledge assessment, six-item clinical self-assessment, and two-item self-reported likelihood to prescribe GAHT (1–7 scale).

Key Results

Of 1596 eligible residents, 623 (39.0%) were included in the analysis. Transphobia scores were low at baseline (mean = 2.09, SD = 0.90). Transphobia decreased in both the clinical and cultural arms from 2.07 to 1.78 (p < 0.001) and from 2.11 to 1.81 (p < 0.001), respectively. At baseline, residents had a higher likelihood to continue a patient’s GAHT prescription (mean = 5.26, SD = 1.68) than to start a patient on GAHT (mean = 3.55, SD = 1.71). After watching the webinars, both arms were statistically significantly more likely to continue GAHT (mean = 5.66, SD = 1.48) and start GAHT (mean = 4.29, SD = 1.73). Knowledge scores and comfort addressing health care needs of trans patients were greater in the clinical arm; there were no other differences in changes between the two randomized groups.

Conclusions

We found that brief educational videos had measurable effects on attitudes and likelihood to prescribe GAHT in IM resident PCPs. Addressing clinical knowledge gaps may be a more efficient way to achieve these results than focusing on cultural competency.