Abstract
Background: Medical professionals seem unprepared to provide care and understand the health needs of transgender and gender diverse (TGD) people. Therefore, this research aimed to explore the medical students' attitudes and performance on a transgender healthcare simulation scenario.
Methods: We designed and evaluated a simulation scenario to train Obstetrics and Gynecology (OB/GYN) clerkship students in caring for TGD patients. The simulation and cross-sectional data collection took place in a university hospital located in the northeast of Brazil. From January to June 2023, the OB/GYN clerkship medical students were invited to run a simulated scenario. The undergraduates answered a simplified "Scale of Satisfaction with Simulated Clinical Experiences". This research was approved by the institution's Research Ethics Committee and received funding from the Brazilian Association of Medical Education.
Results: Almost a third of the students reported that they had not the opportunity to differentiate between gender identity and biological sex during their undergraduate program. 74% believe that an individual's sexual orientation has an influence on the care they receive. The scenario simulated a consultation for a trans man with secondary amenorrhea. Two self-declared trans men took part as standard patients. Of the 25 undergraduate students taking part, 92% managed to avoid behavior that reflected value judgements. However, 44% found it difficult to use their social name and the corresponding pronouns. 60% of the participants found it difficult to provide counselling on health promotion and prevention. In the debriefing, the students found it challenging to address sexual practices and reported a lack of knowledge about the referral process to TGD care services. Undergraduates were receptive when exposed to the scenario developed.
Conclusions: Realistic simulation can be useful for exposing students to scenarios that are little explored during their graduation and foster the development of cultural competences in caring for TGD individuals.