Abstract
BACKGROUND: Transgender women (TW) in Puerto Rico (PR) face social stigmatization. Physicians' transgender stigma can have detrimental consequences for TW's health. PURPOSE: The objective of this study was to document physicians' knowledge, competencies, and attitudes towards TW in PR and study their associations with stigma towards TW. METHODS: We implemented an exploratory sequential mixed-methods study. We used in-depth interviews (n=30) and self-administered questionnaire (n=255). RESULTS: Qualitative results illustrated lack of recognition of the needs of TW; they also evidenced the impact of stigmatizing attitudes on clinical decisions. Quantitative results showed that more willingness and knowledge to provide health services to TW were negatively associated with stigma. Participants who reported history of training in working with TW presented significantly less stigma than participants who had not received such training. CONCLUSION: In order to provide stigma-free services for TW in PR, specialized training regarding the particular needs of this population is needed.