Medical Educators' Perceptions and Experiences of Transgender Curriculum in Barbados.

Purpose: This study explored medical educators' understanding of the term transgender and their attitudes and perspectives regarding (1) health system responsiveness to transgender needs and (2) transgender curriculum in medical education. Methods: The study employed purposive sampling of medical educators responsible for design and delivery of curriculum. Fifteen of 18 eligible educators participated in Zoom focus groups (FG1 n=7, FG2 n=8). FGs averaged 93 min and were recorded, transcribed verbatim, and analyzed using a qualitative interpretivist methodology with deductive and inductive coding assisted by NVivo 12 Pro software. Results: Educators were knowledgeable about the term transgender and the physical and psychosocial needs of transgender people. Participants viewed transgender care as a significant emerging health area. However, infrequent personal or clinical contact, coupled with constraints in human and other resources, resulted in the perception that transgender content as a stand-alone component of curriculum is difficult to justify. Participants articulated a need for broad-based diversity content, including disabilities, primarily at the undergraduate level. Educators saw transgender health as relevant for undergraduate-level psychiatry and postgraduate medical specializations. Analysis and discussion framed participant perspectives in the context of stigma, discrimination, and medicolegal and health systems that impede access to health care for transgender people. Conclusion: Participants demonstrated knowledge of transgender and transgender health care needs. Areas for improvements in health care responsiveness were identified, particularly related to structural stigma and discrimination. Although participants expressed interest in including transgender health in the curriculum, this would require pragmatic optimization of teaching resources.

Attitudes Toward Transgender People Among Future Caribbean Doctors.

The attitudes of medical students toward transgender people have important implications for the future quality of healthcare for Caribbean transgender patients. This paper examined the attitudes and beliefs of Caribbean medical students toward transgender people, provides psychometric evaluation of a promising instrument, and considers implications for the development of transgender curricula in Caribbean medical education. Medical students (N = 205; 155 women, 43 men, 7 unstated) enrolled at a publicly supported Caribbean university completed the Transgender Attitudes and Beliefs Scale (TABS; Kanamori et al., 2017). Internal consistency was strong for the total TABS (α = .93) and more variable for the three subscales: interpersonal comfort (IC: α = .91), sex/gender beliefs (SGB: α = .89), and human value (HV: α = .74). Confirmatory factor analysis demonstrated acceptable overall fit for the three-factor model. There were no significant gender differences in overall attitudes toward transgender people as measured by the total TABS score; women reported higher IC scores. Scores were not correlated with age or with year in medical school. Students reported significantly more tolerant attitudes on the HV scale than on IC or SGB scales. Psychometric findings establish measurement invariance and provide support for further use of the TABS in the Caribbean. We discuss implications for medical curriculum development, including use of the TABS as a tool for medical students to reflect on their individual attitudes and beliefs regarding transgender people.

Factors Associated With and Barriers to Disclosure of a Sexual Assault to Formal On-Campus Resources Among College Students.

Sexual assault on college campuses occurs at high rates, but disclosure to formal on-campus resources remains low. This study used a mixed methodological survey to explore demographic and social characteristics of students who formally reported their assaults and those who did not and examined barriers to formal disclosure. Responses revealed that students who disclosed to formal on-campus resources suffered frequent polyvictimization, had high rates of physical and emotional consequences, and were mostly White women involved in campus organizations. Barriers to formal resource utilization were identified at the individual, interpersonal, organizational, and community levels.

Evaluation of a Social Norms Sexual Violence Prevention Marketing Campaign Targeted Toward College Men: Attitudes, Beliefs, and Behaviors Over 5 Years.

The article evaluates the effectiveness of a 5-year social norms sexual violence prevention marketing campaign designed specifically for men on a large public university in the Southeastern United States. From 2010 through 2014, 4,158 men were asked about their self-reported attitudes, beliefs, and behavior related to sexual violence as well as their perception of their peers' attitudes, beliefs, and behaviors. Using social norms theory, a social norms marketing campaign was developed to target highly discrepant attitudes, beliefs, and behaviors. Results indicate that both self-reported and perception of peer attitudes and beliefs improved over time, and the discrepancy between the two reduced over time. In addition, the frequency of positive and prosocial self-reported behavior increased on five of the six indicators. This study represents a significant contribution to the literature, as it uses 5 years of data and includes behavioral indicators to add evidence for the efficacy of targeting misperceptions of social norms as a mechanism to engage men in gender-based violence prevention.