Knowledge, attitudes, and practices of healthcare providers toward gender dysphoria in Saudi Arabia

Background: Gender dysphoria (GD) involves a marked incongruence between an individual's experienced gender and their sex assigned at birth. Individuals with GD often experience a strong desire to be treated as another gender and frequently face significant health disparities, including limited access to care, higher risks of depression, and suicide. These challenges are often exacerbated by healthcare providers' knowledge gaps and discriminatory attitudes. This study's objective is to assess the knowledge, attitudes, and practices (KAP) of healthcare providers in Saudi Arabia regarding GD and to identify gaps that could inform targeted educational interventions. Methods: A cross-sectional online survey was conducted with healthcare providers in Saudi Arabia (Nov 2024-Jun 2025). A total of 156 responses were gathered. The questionnaire included domains of knowledge (9 items), attitude (11 items), and practice (4 items) on a 7-point Likert scale. Missing responses, including "I don't know," were imputed. Descriptive statistics were used to summarize participant responses. Associations among knowledge, attitude, and practice scores were examined using Spearman's rank-order correlation, with additional subgroup analyses conducted to explore variations by demographic characteristics. Results: Participants demonstrated moderate to strong knowledge and generally positive attitudes toward individuals with GD, particularly regarding pronoun use, mental health assessment, and awareness of health disparities. However, practical engagement was limited, with only 19% reporting direct clinical experience and a few having received GD-related training. Scores varied by age, training level, and specialty, as respondents aged 24-39 years showed the strongest knowledge and attitude scores, and practice scores were highest among those aged 40-49 years, while senior registrars demonstrated the highest overall KAP scores, and psychiatry showed the strongest overall specialty profile. Conclusion: Healthcare providers demonstrate foundational knowledge and supportive attitudes but limited practical experience in managing GD. Targeted training and structured clinical exposure are recommended to improve culturally competent and inclusive care.