Abstract Introduction Transgender individuals experience significant barriers when accessing healthcare. Barriers posed by healthcare providers due to negative attitudes, limited clinical knowledge, and systemic gaps in training can exacerbate disparities in physical and mental health outcomes for transgender individuals. While global literature highlights progress in gender-affirming care, there remains a paucity of research exploring physicians’ attitudes within Asian healthcare systems, where sociocultural and religious influences may uniquely shape professional perceptions. Understanding these factors is vital to designing inclusive curricula and policies that promote affirming transgender care. Objective This study aimed to evaluate physicians’ attitudes and beliefs toward transgender individuals using a validated psychometric tool and to identify sociodemographic and medical training factors that influence these attitudes and comfort levels in clinical practice. Methods A cross-sectional, anonymous online survey was disseminated to 256 physicians across six specialties likely to engage in transgender care. The Transgender Attitudes and Beliefs Scale (TABS) was used to assess three dimensions: Interpersonal Comfort, Sex/Gender Beliefs, and Human Value, through 29 items rated on a seven-point Likert scale (1=strongly disagree, 7=strongly agree). Reverse-scored items were adjusted to reduce acquiescence bias, with higher scores indicating more positive attitudes. Additional items measured perceived experience, knowledge, and comfort in providing transgender care. Statistical analysis was conducted using R(v4.2.2), employing descriptive statistics, ANOVA/Kruskal-Wallis tests, chi-square tests, and multiple regression to identify predictors of TABS scores. The study was approved by the Institutional Ethics Review Board (Ref. No. DSRB: 2022/00216), and participants provided consent prior to participation. Results Total of 128 responses were analyzed. Participants represented diverse age groups and specialties, with the largest proportion from Family Medicine. The mean total TABS score was 163.85 (SD=27.21), indicating generally positive attitudes. Subscale means were 81.66 for Interpersonal Comfort, 48.95 for Sex/Gender Beliefs, and 33.23 for Human Value, suggesting high regard for human dignity but variable endorsement of gender diversity. Regression analysis identified religion as a significant predictor of total TABS score (p=0.04), with the strongest effect observed in the Sex/Gender Beliefs domain (p=0.003). Female respondents exhibited more positive attitudes than males (OR=1.3, 95% CI 1.07–1.48). Respondents who rated themselves as more knowledgeable were substantially more comfortable providing transgender care (70.5% vs 3.6%, p0.001). Positive attitudes were also associated with higher self-reported comfort (39.3% vs 18.8%, p=0.05). Conclusions This study provides one of the first insights into physicians’ attitudes toward transgender care within an Asian healthcare setting. Although overall attitudes were positive, findings underscore persistent knowledge gaps and the influence of gender and religion on clinicians’ perceptions during provision of care. The significant relationship between knowledge and comfort demonstrates that education and training are key determinants to affirming practice. Incorporating structured, evidence-based modules on gender diversity and transgender health into both undergraduate and postgraduate curricula could improve confidence, reduce bias, and enhance quality of care in healthcare providers. Continuing professional development, interprofessional collaboration, and partnerships with transgender advocacy groups are essential to sustain attitudinal change. Addressing these gaps will help foster a more inclusive, empathetic, and equitable healthcare environment for gender-diverse individuals. Disclosure No
Khoo et al. (Mon,) studied this question.
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