Structural and Social Inclusivity of Transgender and Nonbinary Students in U.S. Medical Schools and Schools of Public Health Programming

Purpose: We characterize trans-inclusive social and structural educational programming at Association of American Medical Colleges-affiliated U.S. allopathic medical and Council on Education for Public Health-accredited schools of public health using responses from deans and administrators. Methods: Between December 2019 and February 2020, the Public Health and Medical Schools Transgender-Inclusive Educational Programming Study surveyed deans, administrators, and students via email about trans-inclusive social and structural educational programming strategies at their institution. Evaluated social programming included training topics, social events, and direct communications. Assessed structural strategies included admissions, policies, and mentorship. Descriptive statistics were performed for all variables while stratifying by medical versus public health schools. Bivariate analyses were used to examine differences between strata and chi-square or Fisher's exact tests, accordingly, to analyze programming strategies. Results: Of 335 deans and administrators contacted, 65 completed the survey (19% response rate) and 55.4% were from public health. Most were deans (87.7%), from public institutions (69.2%), between 51 and 59 years old (44.6%), and were ciswomen (63.5%). Comparisons of medical versus public health schools demonstrated significant differences in trans-inclusive strategies such as gender competency training (58.6% vs. 36.1%); trans-inclusive lectures (44.8% vs. 30.6%); honoring trans students' names in-person (75.9% vs. 61.1%); and goals to increase trans representation as researchers (37.5% vs. 26.7%). Conclusions: Policies aimed at creating trans-inclusive environments in these institutions should focus on bolstering affirming structural programming, encouraging prospective trans applicants, mentoring trans students' research ambitions, and consistently using students' lived names, pronouns, and gender markers in all documentation and communications.