Health Professions Students' Knowledge, Skills, and Attitudes Toward Transgender Healthcare.

Most graduate medical education programs dedicate almost no time in their curricula to the topic of transgender health. This study aimed to assess medical (MD), physician assistant (PA), and clinical nutrition (CN) students' self-reported knowledge, skills, and attitudes toward healthcare for transgender patients and identify differences between groups. This cross-sectional study was conducted at a single United States academic health center. Students were surveyed using a questionnaire with 16 Likert-type items. A total of 178 MD, 96 PA, and 28 CN students completed the survey. Most (67%) respondents reported a "high" level of personal comfort in caring for a transgender patient, with no difference between groups (p = .57). MD students were more likely than PA or CN students to report greater knowledge of gender dysphoria management (p < .001) and transgender care guidelines (p < .001), as well as a greater skill level in caring for patients with gender dysphoria (p = .009) and inquiring about gender identity (p < .001). All three groups, however, reported overall "low" or "intermediate" levels of knowledge and skills. Our research demonstrates that MD, PA, and CN students exhibit an equally high degree of personal comfort in caring for transgender patients but lack the knowledge and skills to confidently care for them.

Developing a Curriculum on Transgender Health Care for Physician Assistant Students.

PURPOSE: Our goal was to (1) evaluate physician assistant (PA) students' knowledge, skills, and attitudes toward transgender patients, (2) develop and deliver a lecture on transgender health care, and (3) determine changes in knowledge, skills, and attitudes postlecture. METHODS: A 32-item survey was developed and emailed to PA students. Students were then invited to a 2-hour lecture on transgender-specific psychosocial topics and clinical skills plus medical treatment for gender dysphoria. Lecture attendees retook the survey after 2 weeks. RESULTS: Initial mean self-assessment scores regarding clinical knowledge and skills were below 3 on a 7-point Likert scale. All measures improved following the lecture (p < .001 for all). Overall, 86.7% of students were interested in the addition of transgender health into their didactic curriculum. CONCLUSIONS: Our results illustrate insufficient student competence in transgender medicine. Our proposed transgender curriculum may be a useful guide for educators wanting to integrate this topic into their instruction.

Two-hit exposure to polychlorinated biphenyls at gestational and juvenile life stages: 2. Sex-specific neuromolecular effects in the brain.

Exposures to polychlorinated biphenyls (PCBs) during early development have long-lasting, sexually dimorphic consequences on adult brain and behavior. However, few studies have investigated their effects during juvenile development, a time when increases in pubertal hormones influence brain maturation. Here, male and female Sprague Dawley rats were exposed to PCBs (Aroclor 1221, 1 mg/kg/day) or vehicle prenatally, during juvenile development, or both, and their effects on serum hormone concentrations, gene expression, and DNA methylation were assessed in adulthood. Gene expression in male but not female brains was affected by 2-hits of PCBs, a result that paralleled behavioral effects of PCBs. Furthermore, the second hit often changed the effects of a first hit in complex ways. Thus, PCB exposures during critical fetal and juvenile developmental periods result in unique neuromolecular phenotypes, with males most vulnerable to the treatments.