Resident Comfort Managing Menstrual Suppression in Gender Diverse Adolescents Across Family Medicine, Pediatrics, and Obstetrics and Gynecology Specialties: A Cross-Sectional Survey Study

Study Objective: To assess resident physician comfort regarding menstrual suppression in gender diverse adolescents (GDA). Secondly, to explore perceived barriers to managing menstrual suppression in GDA. Methods: This is an IRB-approved survey study of Family Medicine (FM), Pediatrics, and Obstetrics and Gynecology (OBGYN) residents from all ACGME-accredited programs. Participants completed a survey evaluating their comfort managing: (1) a cisgender adolescent desiring contraception; (2) a cisgender adolescent with dysmenorrhea; and (3) a GDA desiring menstrual suppression. Participants selected their top 3 barriers for each case. Results: A total of 375 participants consented to the survey, and 293 (78%) participants completed the survey. Of the total, 169 (45%) were FM residents, 99 (26%) were Pediatrics residents, and 62 (17%) were OBGYN residents. The majority of FM, Pediatrics, and OBGYN residents were comfortable managing contraception and menstrual concerns in cisgender patients, while 29% of FM residents, 27% of Pediatrics residents, and 50% of OBGYN residents were comfortable managing menstrual suppression in GDA. OBGYN residents were significantly more likely to report comfort managing menstrual suppression in GDA compared to FM (OR 2.44, 95% CI [1.35, 4.45], p = .003) and Pediatrics (OR 2.64, 95% CI [1.37, 5.15], p = .004). All 3 specialties selected lack of education/experience as the top barrier in caring for GDA. Conclusion: FM, Pediatrics, and OBGYN residents indicated comfort managing contraception and menstrual concerns, yet all residents, especially FM and Pediatrics residents, reported discomfort in managing menstrual suppression in GDA. Efforts should focus on enhancing education on caring for gender diverse patients in all 3 residency programs.