American Council of Academic Plastic Surgeons
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Transgender Surgical Training in US Academic Plastic Surgery Residency Programs
Michael Ha, MB BChir1; Ledibabari M Ngaage, MB BChir1,2; Emily Finkelstein, BS1; Nicholas Hricz, BS1; Kevin Zhu, BS1; Caroline Simon, BS1; Aasheen Qadri, BS1; Joshua S Yoon, MD3; Fan Liang, MD3; Rachel Bluebond-Langner, MD4; Jens U Berli, MD5; Yvonne M Rasko, MD1
1Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, USA 2Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, USA, 3Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, USA, 4Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York City, USA, 5Division of Plastic and Reconstructive Surgery, School of Medicine, Oregon Health & Science University, Portland, USA

Background: Over 1.4 million adults in the U.S. identify as transgender and there has been a significant increase in patients seeking surgical transition. However, the literature is void on the quantity and adequacy of surgical transition training during residency. This study aims to review the current state of gender transition education in US plastic surgery residency programs.
Methods: We performed a cross-sectional study on all accredited independent and integrated plastic surgery residency programs. Information on program curricula was collected from official program websites, and email to or telephone interview with the program coordinator. Programs were also categorized on whether they were affiliated with a “Leaders in LGBT Healthcare” center. Exposure to surgical transition was deemed to be either incidental or structured.
Results: One hundred and thirty programs were included in this study. Most programs provided exposure to gender-affirming surgery (n = 96, 74%), significantly fewer provided structured training (n = 37, 28% vs 74%, p <0.001). Of those who provided formal training, all provided didactic training, 86% provided clinical training (n = 32) and less than half (n = 14, 43%) provided a dedicated rotation. Programs affiliated with “Leaders in LGBT Healthcare” centers were significantly more likely to provide dedicated rotations than their non-affiliated counterparts (p=0.028).
Conclusion: Despite the growing demand for gender transition surgery, only one in four plastic surgery residency programs have structured training in their curriculum. To better serve the transgender population, a universal structured curriculum on gender transition surgery should be created.

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