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Integrating Gender-affirming Surgery Education into a Core Surgery Clerkship: Impact on Medical Student Knowledge and Confidence
Calvin R. Schuster
*1, Gabriela Drew
1, Helene F. Hedian
2, Fan Liang
1, Wendy Chen
11Department of Plastic and Reconstructive Surgery, Center for Transgender and Gender Expansive Health, Johns Hopkins University School of Medicine, Baltimore, MD; 2Department of Medicine, Center for Transgender and Gender Expansive Health in Baltimore, Johns Hopkins University School of Medicine, Baltimore, MD
Background: Many physicians feel unprepared to care for transgender and nonbinary (TGNB) patients, a gap largely attributed to limited formal education. Deficiencies in training can contribute to discomfort, lack of confidence, and suboptimal care, perpetuating health disparities. This project aimed to assess baseline medical student knowledge, attitudes, and confidence and evaluate the impact of a gender-affirming surgery (GAS) lecture.
Methods: The 1-hour lecture, administered during two core surgery clerkships, covered gender-affirming chest, genital, and facial reconstruction. Students completed anonymous pre- and post-surveys linked via unique code. Survey domains included demographics, self-reported confidence, and a 13-item knowledge assessment. Bivariate analysis and multivariable linear regression were conducted with age, race, sexuality, gender, prior clerkships, prior TGNB patient exposure, and prior GAC training as covariates.
Results: Overall, 42 students completed pre-surveys and 38 completed post-surveys, yielding 38 paired responses (response rate: 80.9%). A majority (96%) had encountered at least one TGNB patient previously. Respondents believed learning about GAS during medical school is important: almost all at least somewhat agreed (97%) and most strongly agreed (63%), and all (100%) want to be able to effectively care for TGNB patients. Despite this, pre-lecture most (57%) felt they had not yet received adequate GAS education. Post-lecture, students demonstrated significant improvements in comfort communicating with TGNB patients, familiarity with surgeries, and confidence discussing surgical readiness, fertility preservation, and complications. Mean knowledge assessment scores increased by 28% (Pre: 46% vs. Post: 74%, p<0.001). Lecture participation was independently associated with a significant increase in score (R
2=0.74, β=27.7, p<0.001).
Conclusion: Medical students value GAS education. Integration of a GAS lecture into a core surgery clerkship was associated with significant improvements in student knowledge, comfort, and confidence.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
Back to 2026 Abstracts
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
