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OBJECTIVE: Increasing workforce capacity to provide knowledgeable, skilled, and affirming care for transgender and gender diverse people is critical to reduce health inequities; however, few clinicians receive sufficient training on this topic. This article describes Advancing Excellence in Transgender Health (AETH), an annual international conference that offers continuing professional development on evidence-based medical and behavioral healthcare for transgender and gender diverse people across the lifespan. METHODS: Registration data and post-conference evaluation data were descriptively analyzed to assess conference reach, participant satisfaction, and participant intentions to change practice. RESULTS: Between 2015 and 2022, AETH trained 2677 participants from all US states and 24 countries. Based on post-conference evaluations, 2017-2022, participant satisfaction was high (mean ≥4.4 on a 5-point scale) on all measures, including meeting learning objectives, quality of presentations, and relevance to practice. Participants reported intentions to: implement new information or skills (86.7%); create or revise protocols, policies, and/or procedures (63.2%); and seek additional information (64.2%). To increase equity, the conference waives fees for transgender and gender diverse participants and offers free online sessions. The conference also holds sessions specifically for transgender and gender diverse participants to promote opportunities for community-building, self-care, and professional networking. CONCLUSION: The broad reach of AETH demonstrates a large demand for more continuing professional development on transgender and gender diverse healthcare. This conference has expanded the availability of training designed to increase and enhance clinical workforce capacity to meet the health needs of transgender and gender diverse communities in the US and across the world.
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INTRODUCTION: Suicidality is higher for gender minorities than the general population, yet little is known about suicidality in disabled or older adult gender minorities. METHODS: This study used 2009-2014 Medicare claims to identify people with gender identity-related diagnosis codes (disabled, n=6,678; older adult, n=2,018) and compared their prevalence of suicidality with a 5% random non-gender minority beneficiary sample (disabled, n=535,801; older adult, n=1,700,008). Correlates of suicidality were assessed (via chi-square) for each of the 4 participant groups separately, and then disparities within eligibility status (disabled or older adult) were assessed using logistic regression models, adjusting first for age and mental health chronic conditions and then additionally for Medicaid eligibility, race/ethnicity, or U.S. region (each separately). The primary hypotheses were that gender minority beneficiaries would have higher suicidality but that suicidality disparities would persist after adjusting for covariates. Data were analyzed between 2017 and 2019. RESULTS: Gender minority beneficiaries had higher unadjusted suicidality than non-gender minority beneficiaries in the disabled cohort (18.5% vs 7.1%, p<0.001). Significant suicidality predictors in all 4 groups included the following: age (except in older adult gender minorities), Medicaid eligibility, depression or behavioral health conditions, avoidable hospitalizations, and violence victimization. In age- and mental health-adjusted logistic regression models, gender minorities had higher odds of suicidality than non-gender minority beneficiaries (disabled, OR=1.95, p<0.0001; older adult, OR=2.10, p<0.0001). Disparities were not attenuated after adjusting for Medicaid eligibility, race/ethnicity, or region. CONCLUSIONS: Heightened suicidality among identified gender minority Medicare beneficiaries highlights a pressing need to identify and reduce barriers to wellness in this population.
