Family Physician Scope of Practice for Gender-Affirming Care

Background and Objectives: Physician scope of care for transgender and gender-diverse (TGD) patients is often lacking. To inform educational efforts to improve care for TGD patients, this study sought to better understand the scope of practice for family physicians who provide gender-affirming care (GAC) to TGD patients.Methods: This was a secondary analysis of a previously published study, in which electronic surveys were sent to family physicians and third-year family medicine residents in North Carolina. The present analysis descriptively assessed responses from physicians who indicated providing GAC to TGD patients, to assess scope characteristics, perceived barriers to scope, and resources used when providing care for these patients.Results: Of study participants, 100 physicians reported providing GAC. The majority offered gender-affirming hormone therapy such as estradiol and testosterone and other medications influencing hormones. Physicians also mentioned making referrals for surgical consultation and care coordination for other gender-affirming services. More than half indicated that they practiced GAC with age restrictions prior to the passage of legislation that required age restrictions. The most common perceived barrier to providing care to TGD patients was knowledge and experience. Several resources were cited to support care for TGD patients.Conclusions: Elements of care for TGD patients are within the standard scope of practice for family physicians. Understanding scope details as well as perceived barriers to and resources for providing care for TGD patients among current providers can better inform medical education efforts.