Abstract
BACKGROUND: Transgender and gender-diverse individuals experience higher burdens of health disparities compared to their cisgender counterparts. Contributing factors include decreased access and denial of care, experiences and fear of medical violence, and increasing legislative barriers. These patients often report having to educate healthcare professionals due to lack of expertise of transgender and gender-diverse issues within the medical community, with training deficits observed at all levels of medical training. AIMS: We surveyed pediatric anesthesiology fellowship directors in the United States and Canada with an aim to describe the current state of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content across pediatric anesthesiology fellowship training programs. METHODS: A 25-question descriptive, cross-sectional, electronic survey was created and distributed to all pediatric anesthesiology fellowship program directors in the United States and Canada investigating the inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum (if present) for pediatric anesthesiology fellows. RESULTS: A total of 33 responses were collected from 69 total invited programs. Diversity, equity, and inclusion curricula were present in 93.5% (29/31) of fellowship programs but only 29% (9/31) of programs included content specific to transgender and gender-diverse populations. Just 17% (5/29) of program directors thought their curriculum adequately prepared their graduates to care for transgender and gender-diverse patients. However, 69% (20/29) expressed a desire to see more educational content included in the future. Lack of knowledgeable faculty educators and time were the most chosen perceived barriers to inclusion. CONCLUSIONS: To our knowledge, this study is the first to evaluate pediatric anesthesiology fellowship curricula for inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum. As the population of known transgender and gender-diverse youth increases, all pediatric anesthesiologists must be equipped to treat this population with appropriate clinical and cultural sensitivity. Future endeavors must include robust sexual orientation and gender identity data collection, access to educational materials from content experts, recruitment and empowerment of LGBTQ+ anesthesiologists, and increased dedicated time toward diversity, equity, and inclusion education, specifically in regard to the transgender and gender-diverse population. CLINICAL IMPLICATIONS: Lack of physician education on the care of transgender and gender-diverse patients is one of several factors contributing to the health disparities seen in this population; training deficits in the care of transgender and gender-diverse patients have been observed in all levels of medical training. Our data show a critical deficiency of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content in pediatric anesthesiology fellowships in the United States and Canada and identify potential barriers to the inclusion of such content.