Students, faculty and staff embrace transgender medicine curriculum in the College of Medicine

“When we were putting the transgender medicine curriculum together, it really wasn't being taught on a larger landscape. We integrated it into the basic science curriculum so that in the students’ first and second year, when they were already learning about hormonal pathways and sexual development, they were also learning about gender diversity,” says Pickle.

“Instead of placing transgender health separate in a more ethics or social content course, we integrated it into the foundational science part of the curriculum,” she adds. “The idea was that we could then give students the tools, like understanding the physiology of gender affirming hormones, and also prepare them for inclusive conversations with our patients as partners in their gender journeys.”

Very little exists in the way of research about transgender medical students in the United States. Stanford University conducted a study published in 2015 titled “Sexual and Gender Minority Identity Disclosure During Undergraduate Medical Education: In the Closet in Medical School.” More than 175 medical schools in the U.S. and Canada were surveyed about their students’ sexual identity, if they were “out,” and if not, why they chose to mask their identity. Of the 5,812 completed surveys, 920 students across 152 institutions identified as a sexual or gender minority. Of those, 912 identified as sexual minority, and 29.5% concealed their sexual identity in medical school. In addition, 43.5% reported a fear of discrimination in medical school. Of the 35 who identified as gender minority, 60% concealed their identity for fear of discrimination and feeling a lack of support.

“Many of the skills we teach in the transgender medicine curricula are transferable to caring for minoritized or marginalized identities outside of gender identity,” Pickle says. “The concepts of inclusive history-taking, trauma-informed approaches to the physical exam and using inclusive language can be used to create an equitable and safe clinical environment for all patients, especially those who have been historically marginalized.” 

Connie Chen is in their second year as a student at the UC College of Medicine. They say the training they are getting in the transgender medicine curriculum is crucial to be able to do what they want to do in their medical career.

“This is a community that is incredibly vulnerable, and luckily we’re finally having conversations about how marginalized people are treated in medicine,” Chen says. “Having adequate training to treat certain populations, even the ones that I’m not necessarily a part of, is important for me to provide the best care that I can.”

All four of the students interviewed for this article shy away from the idea that they are pioneers or trailblazers in transgender medicine.

Schram says being part of a group that they identify with as a member means learning the history of that identity. They have studied the history of LGBTQ+ rights including those of trans people in the medical field, but they didn’t necessarily have visible mentors ahead of them, so as they came out more publicly and visibly, they had a class behind them that they knew were full of out and open people.

“But it does create this dynamic for me that when I go into the clinic and I'm like, ‘Oh if I don't do XYZ today, will that cause consequences a year from now?’” Schram says. “It can be really frustrating when it's as simple as, for example, in one of our surgical suites you have to go through a gender[-identified] changing room to get to the operating room. So you are required to choose a gender, and I panicked. I felt I knew what the correct answer was for that situation, but I panicked because I was with someone who was also very confused as to what to do.”

Student Lutwak says for him the situation is different because of his binary identity which makes invisibility an option for him currently and in the future.