Are urologists prepared for transgender health care? Evidence of knowledge and confidence gaps

PURPOSE: Transgender individuals experience significant disparities in healthcare access and quality, often owing to limited provider training and awareness. This study aimed to assess the knowledge, attitudes, and clinical exposure of Mexican urologists and urology residents in relation to transgender patient care and to identify potential gaps that may affect treatment quality and access. METHODS: An anonymous survey was distributed to board-certified urologists and urology residents between April and May 2025. The questionnaire included a 5-point Likert scale to evaluate participants' knowledge, confidence, and comfort when treating transgender patients. The questions also assessed clinical experience, familiarity with gender identity and appropriate pronouns, ability to provide endocrine and surgical care, and awareness of healthcare disparities. A total of 322 responses were analyzed using descriptive statistics and t-tests to identify significant trends. RESULTS: Among the respondents, 53.7% had never attended to a transgender patient, and 71.1% were not currently caring for any. Only 15.5% reported a strong knowledge base in transgender health and only 7.4% felt confident in performing gender-affirming surgery. While 62.1% felt comfortable discussing gender identity, only 58.3% could clearly distinguish it from their sexual orientation. Urology residents reported greater comfort and awareness than certified urologists did. Less than half (48.4%) strongly supported transgender care in residency programs. CONCLUSION: There is a marked gap in transgender-related knowledge and clinical exposure between Mexican urologists and residents. These findings underscore the urgent need to integrate structured transgender health education into urological training and continuing medical education to promote equitable, competent, and inclusive care.