A new paper in Family Practice indicates that only around half of transgender people report supportive primary-care experiences. Participants with more supportive healthcare experiences had less psychological distress as well as a lower likelihood for self-injury and thoughts of suicide.

Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared to cisgender people. While access to appropriate medical care is particularly important to the wellbeing of transgender people, health professionals often report discomfort and uncertainty about how to care for transgender patients. Medical schools often do not provide specific training in this area.

Researchers here analyzed data from the 2018 “Counting Ourselves” survey of 948 transgender people in New Zealand. Only 56.9% of respondents felt they were treated the same as any other patient in routine appointments. Moreover, fewer than half of respondents (48.2%) reported their primary-care doctors were supportive of their needs relating to gender-affirming care. Appropriate transgender knowledge was relatively rare among primary-care doctors. 

Further, almost half of respondents (47%) reported that they had to teach someone about trans or non-binary people to receive appropriate care. Fewer than a quarter of transgender people (23.8%) had a primary-care physician who demonstrated they knew a lot about gender-affirming care. Medical providers being willing to educate themselves on gender-affirming care was only reported by 42.6% of respondents.

The researchers reported that each additional supportive experience with a primary-care physician was associated with an 11% decrease in the likelihood of a suicide attempt. At the same time, each negative healthcare experience resulted in a 20% increase in the likelihood of suicide attempts.

“Medical schools have an important role to play in ensuring our future doctors have the knowledge and confidence needed to provide supportive care to their transgender patients,” says one of the paper’s authors, Rona Carroll, PhD, of the University of Otago in New Zealand. “Postgraduate general practice training programs should incorporate transgender healthcare as a key skill in their curricula.”