Funded Projects

Talking Gender in Pediatric Primary Care

Project Year

2023

City & State

Burlington, Vermont

Program Name

CATCH Resident

Topic

LGBTQ Health

Program Description

"Problem While working at Camp Outright, a 2 week summer camp for queer youth, I ran a transgender health workshop + Q&A. During these workshops, a persistent theme came up. “I can’t talk to my doctor about this.” “I don’t think they’ll know what to do.” There was a general mistrust and lack of faith in the medical community amongst these youth, and I realized that they weren’t wrong to believe it. The WPATH Standards of Care were established about 40 years ago, and they’re still a glossed-over subject in medical education. My experiences with gender-diverse patients have mostly been in elective rotations, and not part of the rigorous medical education curriculum that we all undergo as residents and medical students. This project seeks to work with a local queer youth focused organization to develop educational materials and disseminate them at a local, and possibly state-wide level. Additionally, there are not many gender-affirming care clinics on Vermont, with the largest being the Transgender Youth Program at UVM. This clinic sees children from all across the state, leading to long times between visits due to patient volume. This is especially difficult when managing hormones for youth in/about to undergo puberty, as they require multiple follow ups and labs. Setting + Children affected Per the 2019 YRBS data, there are about 3600 LGBT+ high-school aged, and 1800 middle-school aged youth in Vermont. Physician education at a residency-program level, with goals of reaching a greater Burlington as well as state-level would lead to improved health outcomes working with this population of about 5400 youth in the state of Vermont. I’d like to start the project initially within a residency-level, which would reach patients within our community-based continuity clinics, as well as private practices in Vermont where we rotate through. Project Goal The goal of this project is to develop an educational curriculum for physicians, with input from local LGBT+ youth programming, that is aimed at improving trust and health outcomes within the gender-diverse youth community in Burlington and beyond. This will be with close input and help from the local community organization: Outright Vermont. Proposed Intervention The goal would be to develop physician educational modules with community input. Specifically, from focus groups and interviews from Outright Vermont youth programming such as the monthly Trans Parent group or the biweekly Trans Group. Integrating personal good and bad experiences with the medical system is essential for empathetic and patient-driven care. I’d present educational materials that would be prepared ahead of time, and ask for direct feedback on what is relevant/needs to be changed, so that modules would include only the most pertinent and important points. With a community-driven education module in hand, these would be piloted with pediatric residents. They would also take a pre-post survey of their comfort and knowledge of working with gender-diverse youth. It’s also essential to gather feedback from physicians to see if they have further questions or gaps in knowledge which I’d be able to discuss with Outright programming again. This would help open a direct dialogue between a historically underserved population and the medical system. Anticipated Outcomes Ideal outcomes of this project would include: Increasing trust in the medical system for participating gender-diverse youth and their families. Improving health outcomes for gender-diverse youth, and reducing their reliance on specialty clinics such as the UVM Transgender Youth Program (for non-specialty services). Increasing confidence and knowledge for participating physicians, when working with gender-diverse youth. Producing an effective, portable, and scalable curriculum that can be applied beyond a resident education program."

Project Goal

The goal of this project is to develop an easily accessible online training module aimed at physicians. The information in this module will contain up to date literature on working with gender-diverse youth, and have direct input from the local community. The hope is that this will lead to improved access to gender-affirming medical homes, improved trust in the medical system for gender-diverse youth and families, and improved health outcomes.

Project Objective 1

By the end of 2023, I will have worked with Outright Vermont staff to create physician-specific educational materials using up to date medical literature on the Core Achieve platform. These modules will have been reviewed by at least two physicians, two staff members from Outright Vermont, and one focus group run at Outright Vermont.

Project Objective 2

Starting from October 2023 to February 2024, I will have worked with Outright staff to hold at least 3 focus groups and 10 individual interviews with gender-diverse youth and their families discussing educational goals for physicians working with gender-diverse youth.

Project Objective 3

By the beginning of 2024, the module rollout will begin and a pilot will be run with UVM pediatric residents to assess improvements in self-competence working with gender-diverse youth. This data will be collected and presented at the residency PEC and conferences as appropriate. I will aim for a 70% completion rate of modules with pre-post surveys prior to the end of March 2024 in the pediatric residency program.

AAP District

District I

Institutional Name

University of Vermont Medical Center

Contact 1

Benjamin Kim