Among transgender and gender diverse (TGD) people, 18% were diagnosed with an eating disorder (ED) in the past year, compared to <2% of cisgender people [1]. TGD people experience internal stressors, such as gender dysphoria, and external stressors, such as discrimination, which contribute to an elevated rate of EDs.

Clinicians may receive insufficient medical training about EDs [2]. Few clinicians are specifically educated on how to care for TGD people with EDs, and thus they may fail to address the unique challenges faced by these patients, hindering their recovery [3]. Furthermore, clinicians report variable attitudes toward working with TGD patients, which may be improved through convenient and accessible targeted digital training [4]. However, no in-depth clinician training activities currently focus on TGD people with EDs [5].

In this study, we report on the development and evaluation of a training module on treating TGD people with EDs for health care workers in primary care settings (Multimedia Appendix 1). The structure of the module aligns with principles of adult learning theory (eg, andragogy) and student-centered learning (eg, scaffolding) by emphasizing self-directed, practice-based learning and application of progressively more advanced skills to clinical scenarios [6].

As lack of institutional support represents a significant obstacle to producing clinician-training materials for marginalized populations, we demonstrate the feasibility of a digital approach requiring minimal technical and financial support [6].

Of 102 participants who completed the preintervention survey, 87 (85%) also completed the postintervention survey and were included in the study. Most participants were cisgender, white or Asian, and had TGD and/or lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual (LGBTQIA+) friends (Table 1).

As shown in Table 2, paired 2-tailed t tests identified significant increases in all 3 subsections; the largest increases were observed on self-efficacy statements, such as identifying harm reduction strategies for gender dysphoria (+2.39; P<.001). Only 2 statements, on believing TGD identities are valid and being interested in learning about TGD health interventions, did not significantly increase, potentially due to high pretest scores. Participants indicated high levels of satisfaction, with mean ratings between 5.70 and 6.45.

The module was improved based on feedback (eg, adding more case study questions); the module will be made eligible for continuing medical education credits and promoted through the National LGBTQIA+ Health Education Center.

To address disparities in ED risk and outcomes among TGD patients, we developed an hour-long self-paced learning module that included 6 sections with accompanying review questions after each section, and we piloted the module with a cohort of 87 medical school students. Prior to completing the module, students scored highly in the attitudes and beliefs subsections but lower in the self-efficacy subsection, suggesting that while the vast majority of students supported TGD people and had TGD and/or LGBTQIA+ friends, they remained uncertain about how to help TGD patients in a clinical setting. After completing the education module, the students showed statistically significant improvements in all 3 subsections, with the largest improvements in self-efficacy. Students reflected that they gained valuable information from the module, oftentimes despite already having some familiarity with the topic, and they felt confident applying this new information in a clinical setting.

Consistent with prior studies and adult learning theory [6], students found application-based questions to be most helpful. In particular, students reported that the case study questions, which present hypothetical patient care scenarios, meaningfully improved their self-efficacy toward applying concepts in the clinical setting.

Results are limited by the student participant pool, who may not be representative of primary care workers, especially those from different locations and/or political climates. Social desirability bias may have skewed the scores, and skills-based learning was not tested. Participant interviews may further elucidate module strengths and weaknesses; the module may also be enhanced through interactive elements not possible in Google Slides, such as clickable answers.

Supportive and respectful attitudes alone are insufficient to ensure that TGD patients receive high-quality medical care. During a time of limited institutional support for LGBTQIA+ health equity, publicly and digitally accessible clinician training activities that apply this free, simple, and effective model can allow students to learn more advanced clinical skills for addressing a specific health disparity in a subpopulation of LGBTQIA+ patients.