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Kamran R, Chan C, Jackman VA, Lee AC, Suk Y, Jackman L, Ditkofsky N, Nguyen E, Probyn L, Doria AS. Transgender and Gender Diverse Medical Education in Radiology: A Systematic Review. Acad Radiol 2024; 31:4272-4285. [PMID: 39304375 DOI: 10.1016/j.acra.2024.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/26/2024] [Accepted: 09/01/2024] [Indexed: 09/22/2024]
Abstract
RATIONALE AND OBJECTIVES Physicians report a lack of Transgender and Gender Diverse (TGD) health competency for medical imaging. This knowledge gap contributes to negative medical imaging experiences, discrimination, stigma, and diagnostic errors for TGD individuals. Medical education plays an important role in improving this. However, the current landscape and gaps in TGD medical education in radiology is underexplored. We aimed to fill the knowledge gap on the current state of TGD medical education in radiology. MATERIALS AND METHODS A PRISMA and SWiM guideline-compliant systematic review on TGD medical education in radiology was performed. Four databases were searched: Medline, Embase, Web of Science, and Scopus from inception to May 13, 2024. Article screening and extraction occurred independently and in duplicate. Narrative synthesis was performed on TGD medical education material in radiology, educational recommendations, barriers/enablers to education, and current guidelines. RESULTS A total of 4360 records were identified with 76 articles included. Most articles (52, 68%) were from the United States. Most articles aimed to provide recommendations for TGD medical education in radiology (53, 69.7%). Some articles focused on developing medical education (7, 9.2%), evaluating medical education (7, 9.2%), evaluating guidelines (8, 10.5%), or developing guidelines (3, 4%). Identified TGD medical education in radiology is inconsistent, focusing on terminology guides, clinical scenarios, and cultural sensitivity workshops. Many current guidelines for TGD medical imaging were developed through extrapolation of guidance for cisgender patients, demonstrating limited relevance and meaningfulness for TGD patients. CONCLUSION This systematic review identifies a need to develop consistent TGD medical educational material in radiology in partnership with TGD patients to cover patient perspectives and guidance for medical imaging considerations. Results can be used to identify TGD medical education resources in radiology which may be helpful, and guide development of future medical education.
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Affiliation(s)
- Rakhshan Kamran
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Cynthia Chan
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Victoria Anne Jackman
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland, Canada
| | - Ann C Lee
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yujin Suk
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Liam Jackman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Noah Ditkofsky
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elsie Nguyen
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Linda Probyn
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea S Doria
- Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Cathcart-Rake EJ, Ruddy KJ, Tevaarwerk AJ, Jatoi A. Breast cancer and gender-affirming hormone therapy for transgender and gender-diverse (TGD) individuals. Maturitas 2024; 181:107913. [PMID: 38262089 PMCID: PMC10872221 DOI: 10.1016/j.maturitas.2024.107913] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/01/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
Transgender and gender-diverse (TGD) individuals are at risk for breast cancer, but are less likely to undergo screening mammograms and appear to suffer poorer cancer-related outcomes than cisgender women. Gender-affirming hormone therapy (GAHT) may be lifesaving for TGD individuals from the perspective of affirming their core identities; however, the effects of GAHT on cancer development, progression, and outcomes are poorly understood.
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Affiliation(s)
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Amye J Tevaarwerk
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Aminah Jatoi
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
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