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Future docs: how medical students view LGBT family building and evolve with educational opportunities
Endocrinology and Infertility (REI) department for consultation (OR 0.61 CI 0.22-1.70), and 2 (9.1%) and 3 (6.7%), respectively, followed-up for FP discussion (OR 1.50 CI 0.23-9.69). Binomial logistic regression did not identify any variables independently associated with increased probability of having documented REI referral. Both MtF patients pursued sperm cryopreservation, while none of the FtM patients pursued oocyte cryopreservation. CONCLUSIONS: The World Professional Association for Transgender Health and the Endocrine Society clinical guidelines recommend discussion of FP with transgender patients prior to cross-sex hormone and pubertal suppression therapy1,2. In our study FtM patients were more likely than MtF patients to have documented counseling on the impact of these medications on fertility and to receive offer of referral for REI consultation, however this difference was not statistically significant. The overall rate of FP utilization among transgender adolescents was low, which is consistent with recent studies of FP in this population3,4. References: 1. Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int Journal of Transgenderism. 2012;13(4): 165-232. 2. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94: 3132-54. 3. Chen D, Simons L, Johnson EK, et al. Fertility preservation for transgender adolescents. J Adolesc Health. 2017. 4. Nahata L, Tishelman AC, Caltabellotta NM, Quinn GP. Low fertility preservation utilization among transgender youth. J Adolesc Health. 2017. Supported by: REDCap Database supported by Clinical and Translational Science Award (CTSA) Grant (UL1 TR000448) and Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant (P30 CA091842). P-23 Tuesday, October 31, 2017 FUTURE DOCS: HOW MEDICAL STUDENTS VIEW LGBT FAMILY BUILDING AND EVOLVE WITH EDUCATIONAL OPPORTUNITIES. A. Braverman,a V. Short,b K. Lackritz,b E. R. Leubner.c aThomas Jefferson University, Philadelphia, PA; bOBGYN, Thomas Jefferson University, Philadelphia, PA; cMedical Student, Sidney Kimmel Medical College, Philadelphia, PA. OBJECTIVE: To explore third year medical students’ attitudes about LGBT family building and third party reproduction and implications for future medical practice. DESIGN: A quantitative study among 3rd year medical students in an Ob/ Gyn clerkship to assess pre to post-educational intervention changes in attitudes regarding third party parenting (TPP). MATERIALS AND METHODS: Approximately 4 weeks into their Ob/ Gyn rotation, students had a lecture on TPP and participated in a small group discussion with prompts about LGBT family building and the physician’s role in caring for these intended parents. 231 students completed a survey asking about their attitudes towards LGBT family building, donor gametes, and surrogacy prior to starting the rotation and 178 completed this same survey following the discussion groups. Survey respondents rated 10 items using a five-point Likert scale ranging from ‘definitely not’ to ‘definitely’ and subsequently received a total attitude score between 0 and 4, with high scores representing more favorable attitudes. Frequencies of responses were calculated and changes in total attitude scores from pre to post were investigated using t-tests. RESULTS: Survey respondents were 51% female, 48% male, 1% gender non-conforming; heterosexual (93%); and partnered (59%). Attitude about donor gametes and surrogacy changed significantly from pre to post lecture and discussion (p< .03).91% of students were equally comfortable with male or female same sex parenting; 9% expressed discomfort. Transgender parenting was comfortable for 74%. Students felt children would have increased social or emotional burdens raised by same sex parents (82%) and transgender parents (90%). Almost all (99%) of students reported that the ideal parenting age is less than age 35 years. Students preferred anonymous to friends/family gamete donation and overall preferred adoption to donation. Few students (3%) agreed that discussing fertility with a doctor was difficult for heterosexual couples but 67% agreed it is for same sex couples. The majority of students felt that donor conceived persons (DCPs) will have curiosity and rights to the donor’s identity yet feel donors have the right
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to never meet the DCPs. 71% felt donors should not contribute to >15 total DCPs. Few students felt comfortable opting out of helping same sex family building (20%) or transgender parents 21%. CONCLUSIONS: Medical students appear to be comfortable with TPP and LGBT families but have some discomfort with some pathways to parenthood. Preference for donor anonymity may reflect students’ deeper discomfort or concerns with issues that may arise with gamete donors and create long-term impact for these families when working with physicians, e.g. discussing family medical histories with anonymous donors or larger DCP halfsibling groups. Richer discussions for future physicians will facilitate increasing skills and comfort. P-24 Tuesday, October 31, 2017 EVALUATING MEDICAL STUDENTS’ PREPAREDNESS TO WORK WITH THE LESBIAN, GAY, BISEXUAL, AND TRANSGENDER (LGBT) POPULATION. E. R. Leubner, A. Braverman. Thomas Jefferson University, Philadelphia, PA. OBJECTIVE: To determine medical students’ general level of comfort with LGBT family building and their preparedness to work with this population in a health care setting, and whether an educational intervention about assisted reproductive technology (ART) use within the LGBT population increases their level of comfort. DESIGN: This study measured 167 third year medical students at a large East coast medical school throughout their Obstetrics and Gynecology rotation to determine their feelings of preparedness and comfort to work with the LGBT population and whether an educational intervention changes those feelings. The educational module included a one-hour lecture delivered by the department psychologist at the beginning of the rotation and a onehour small group discussion session about ART use within the LGBT population closer to the end of the rotation. MATERIALS AND METHODS: Data was obtained through anonymous student surveys, as part of a larger questionnaire, before the educational intervention and after its completion. The surveys utilized three or four Likertscale questions and open-ended questions about the students’ preparedness and comfort working with the LGBT population and their opinions regarding the educational module. The results of these surveys were then analyzed and compared. RESULTS: The pre-module survey was completed by 227 students, while the post-module survey was completed by 167 students. Students initially reported high levels of comfort when generally interacting with the LGBT population, scoring an average of 4.39 (5¼ most comfortable). Students reported a lower level of preparedness to work with the LGBT population in a health care setting, scoring on average 3.39 (5¼most prepared). After the educational intervention these scores were similar, with averages of 4.40 and 3.55, respectively. Yet, 127 of the 167 students reported that they were ‘‘likely’’ or ‘‘extremely likely’’ to recommend the learning module to other students and the feedback was largely positive citing the need for increased LGBT exposure and education in medical school. CONCLUSIONS: Medical students are generally comfortable interacting with the LGBT population around family building. Despite being comfortable, they desire more opportunities for learning and to practice treating LGBT patients to increase their preparedness to work with this population. P-25 Tuesday, October 31, 2017 FAMILY PLANNING FOR SAME SEX FEMALE COUPLES: DEFINING THE ROLE OF OVULATION INDUCTION IN DONOR INTRAUTERINE INSEMINATION CYCLES. T. G. Nazem,a S. Chang,a H. Morcos,a J. A. Lee,a K. Thornton,a A. B. Copperman,b B. McAvey.a aReproductive Medicine Associates of New York, New York, NY; bObstetrics and Gynecology, RMANY-Mount Sinai, New York, NY. OBJECTIVE: Same sex (SS) female couples seeking reproductive assistance are not necessarily ‘‘infertile.’’ However, many SS women routinely undergo treatments such as ovulation induction (OI), which can result in an increased risk of multiple gestations. This study aimed to determine whether natural ovulation or OI with oral agents results in improved outcomes for fertile SS couples undergoing donor intrauterine insemination (DIUI). DESIGN: Retrospective cohort study.
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to never meet the DCPs. 71% felt donors should not contribute to >15 total DCPs. Few students felt comfortable opting out of helping same sex family building (20%) or transgender parents 21%. CONCLUSIONS: Medical students appear to be comfortable with TPP and LGBT families but have some discomfort with some pathways to parenthood. Preference for donor anonymity may reflect students’ deeper discomfort or concerns with issues that may arise with gamete donors and create long-term impact for these families when working with physicians, e.g. discussing family medical histories with anonymous donors or larger DCP halfsibling groups. Richer discussions for future physicians will facilitate increasing skills and comfort. P-24 Tuesday, October 31, 2017 EVALUATING MEDICAL STUDENTS’ PREPAREDNESS TO WORK WITH THE LESBIAN, GAY, BISEXUAL, AND TRANSGENDER (LGBT) POPULATION. E. R. Leubner, A. Braverman. Thomas Jefferson University, Philadelphia, PA. OBJECTIVE: To determine medical students’ general level of comfort with LGBT family building and their preparedness to work with this population in a health care setting, and whether an educational intervention about assisted reproductive technology (ART) use within the LGBT population increases their level of comfort. DESIGN: This study measured 167 third year medical students at a large East coast medical school throughout their Obstetrics and Gynecology rotation to determine their feelings of preparedness and comfort to work with the LGBT population and whether an educational intervention changes those feelings. The educational module included a one-hour lecture delivered by the department psychologist at the beginning of the rotation and a onehour small group discussion session about ART use within the LGBT population closer to the end of the rotation. MATERIALS AND METHODS: Data was obtained through anonymous student surveys, as part of a larger questionnaire, before the educational intervention and after its completion. The surveys utilized three or four Likertscale questions and open-ended questions about the students’ preparedness and comfort working with the LGBT population and their opinions regarding the educational module. The results of these surveys were then analyzed and compared. RESULTS: The pre-module survey was completed by 227 students, while the post-module survey was completed by 167 students. Students initially reported high levels of comfort when generally interacting with the LGBT population, scoring an average of 4.39 (5¼ most comfortable). Students reported a lower level of preparedness to work with the LGBT population in a health care setting, scoring on average 3.39 (5¼most prepared). After the educational intervention these scores were similar, with averages of 4.40 and 3.55, respectively. Yet, 127 of the 167 students reported that they were ‘‘likely’’ or ‘‘extremely likely’’ to recommend the learning module to other students and the feedback was largely positive citing the need for increased LGBT exposure and education in medical school. CONCLUSIONS: Medical students are generally comfortable interacting with the LGBT population around family building. Despite being comfortable, they desire more opportunities for learning and to practice treating LGBT patients to increase their preparedness to work with this population. P-25 Tuesday, October 31, 2017 FAMILY PLANNING FOR SAME SEX FEMALE COUPLES: DEFINING THE ROLE OF OVULATION INDUCTION IN DONOR INTRAUTERINE INSEMINATION CYCLES. T. G. Nazem,a S. Chang,a H. Morcos,a J. A. Lee,a K. Thornton,a A. B. Copperman,b B. McAvey.a aReproductive Medicine Associates of New York, New York, NY; bObstetrics and Gynecology, RMANY-Mount Sinai, New York, NY. OBJECTIVE: Same sex (SS) female couples seeking reproductive assistance are not necessarily ‘‘infertile.’’ However, many SS women routinely undergo treatments such as ovulation induction (OI), which can result in an increased risk of multiple gestations. This study aimed to determine whether natural ovulation or OI with oral agents results in improved outcomes for fertile SS couples undergoing donor intrauterine insemination (DIUI). DESIGN: Retrospective cohort study.
Vol. 108, No. 3, Supplement, September 2017