ESPE Abstracts

Keywords: Gender Dysphoria/ İncongruence, child and adolescent, attitudes toward transgendered individuals

Objective: To investigate physicians' knowledge and attitudes evaluating children and adolescents with gender dysphoria/incongruence (GD/GI) concerning care and treatment.

Materials and Methods: A questionnaire targeting the knowledge and experiences of physicians and a scale measuring the attitudes toward transgendered individuals (ATTI) were designed in Google form. We contacted pediatric endocrinologists(PEs) and general pediatricians(GPs) via email and/or phone.

Results: 105 PEs and 100 GPs participated in the study. Of the PEs and GPs, the proportion of female were 62.5% and 63%, the median ages were 38(27-67) and 34(24-65) years, the median duration of employment was 5(1-30), and 7.5(1-42) years, and 37% were fellows, 31% were residents respectively. 32.4% of the pediatric endocrinology physicians, were familiar with hormone treatment protocols, 29.5% knew the treatment follow-up, 36.2% were familiar with alternative methods such as binding, compression, filling, and packaging, 39.1% could plan health screenings, 56.2% could provide information regarding treatment side effects. Although 95% of the PEs considered psychiatric evaluation necessary, only approximately 25% considered psychiatric assessment adequate for diagnosing GD/GI. 62.9% of PEs stated that it was their ethical responsibility to treat individuals with GD/GI, the proportion of those who felt that subjects were ready for treatment and felt comfortable treating them was lower (35.2%,27.6%, respectively). The number of PEs who didn't approve puberty suppression, contrary sex hormone therapy, and surgical interventions before 18 years old were 18%, 33.4%,87.6%, respectively. PEs and GPs stated the evaluations they would perform for the first presenting GD/GI individuals as 97%, 85% physical examination, 36%, 68% karyotype, 31%, 74% pelvic/scrotal USG, 58%, 69% hormone measurement, 96%, 94% referral to a psychiatrist, respectively. Among PEs, the proportion of fellows who thought that karyotype and pelvic/scrotal USG should be performed was statistically higher (P=0.044, P=0.012, respectively). However, the proportion of physicians who stated that they knew the treatment protocol and could give information about side effects were higher (P=0.005, P=0.002, P=0.001, respectively). The ATTI score decreased as the duration of occupation of the PEs (r= -0.303, P=0.002) and the age of the GPs increased (r= -0.251, P=0.012).

Conclusions: A significant number of the participants had encountered individuals with GD/GI. However, competency rates in terms of effective treatment and familiar approach were low. Improved training and increased awareness will positively impact the understanding, management, and treatment of GD/GI individuals.