ESPE Abstracts

Introduction: Pediatricians are becoming key figures for gender dysphoric persons, as the number of children seeking information or treatment for gender dysphoria rises. Puberty suppression and affirming approach, have been shown to improve both psychological functioning and physical outcome. However, recent data show that most children referred were too old to receive this treatment. One barrier that can preclude appropriate care is pediatricians’ attitudes towards transgender. Little is known about physicians’ attitudes in general, and pediatricians’ attitudes in particular were not previously assessed.

Aim: To assess the attitudes and beliefs of pediatricians toward transgender people, and to examine associations of demographic and occupational characteristics with these attitudes.

Methods: The transgender attitude and belief scales questionnaire (TABS) was administered to 355 pediatricians. TABS consists of 29 items in three domains: human value, interpersonal comfort and sex/gender beliefs. Answers range from 1–7 on Likert scale, and were analyzed accordingly: favorable attitudes (6–7) and unfavorable (1–5). Demographic and occupational information was analyzed.

Results: The final study cohort comprised 221 (62%) females, 132 (37%) males and 2 who defined themselves as others; 223 (63%) were senior pediatricians and 132 residents; 254 (72%) work in hospitals, and 101 work in the community; 274 (77%) defined themselves as secular and 290 (75%) were born in western countries. Most pediatricians held favorable attitudes in all domains; 94% in human values, 85% for interpersonal comfort domain and 57% in the sex/gender belief domain. In multi variant analysis pediatricians who scored less favorably had distinct demographic characteristics for all segments. Specifically, in the sex/gender belief domain, male gender was associated with two fold increased odds of unfavorable score (odds ratio (OR), 2.1 95% confidence interval (CI) 1.3–3.5) compared to females. Secular pediatricians and those born in non-western countries had 10 fold (OR, 10.3 95% CI 4.5–23.5) and 1.5 fold (OR, 1.5 95% CI 0.8–3.0) odds ratio for unfavorable scores respectively. We found no differences between seniors and residents nor between pediatricians working in hospital compared with those working in the community.

Conclusions: There is still stigma towards transgender persons among pediatricians. The medical community should take measures to promote positive attitudes to make treatment more attainable for transgender adolescents.