U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender-Affirmation Education: A National Survey

With a growing number of individuals seeking gender-affirming surgery, there is a greater need for providers, including oral and maxillofacial surgeons, experienced in the surgical care of transgender people. The aim of this study was to evaluate oral and maxillofacial surgery (OMS) residents’ exposure to the care of transgender people and their perceived importance of education in gender-affirming surgery. All 1,174 OMS residents in accredited U.S. training programs were invited to participate in this cross-sectional study between July 1, 2017, and January 30, 2018. The predictor variables were residents’ gender, program region, program type, and level of training. The outcome variables were frequency of exposure to the care of transgender people, aspects of care covered, perceived importance of such training, and perceived need for fellowship opportunities in gender-affirming surgery. Results were analyzed for 87 respondents, for a 7.4% response rate. Among the respondents, 81.6% were male; 64.4% were training in combined MD degree-OMS certificate programs; and 31% reported having had exposure to the care of transgender people during their residency. On a scale from 1=neutral to 3=very important, the respondents’ mean reported importance of receiving training in gender-affirming surgery was 1.37±0.94. Also, 37.9% reported that fellowship training should be offered in gender-affirming surgery, specifically facial feminization/masculinization. These results showed that the OMS residents had had limited exposure to the care of transgender people, but they perceived that such exposure should be an important component of their training. Further research is needed to collect results from a larger sample and to better understand the role of oral and maxillofacial surgeons in gender-affirmation surgery.