Not all hormone doctors are comfortable treating transgender patients, according to a new survey.

Dr. Michael Irwig, associate professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C., surveyed 80 endocrinology providers, which included endocrinologists, fellows, nurse practitioners and physician assistants, during an endocrinology meeting in 2015. Eighty percent of the participants responded.

The 19-item survey assessed providers' views on treating transgender patients. Since endocrinologists specialize in the endocrine system, which is responsible for regulating hormones in the body, they can play a vital role in caring for transgender patients, particularly those who want to take testosterone or estrogen in order to develop the physical features associated with the gender they identify.

Irwig found that roughly one-third of endocrinologists said they would be unwilling to treat a transgender patient. Overall, 15 percent of the providers said that they were not comfortable having gender identity/sexual orientation discussions with their patients. Thirty-four percent said that they would be slightly comfortable talking about gender identity, and only 20 percent said they were very comfortable discussing this topic with their patients.

In terms of treatment, 58 percent of the providers said that they would be more comfortable treating a patient who is not transgender as opposed to one who is. In addition, not many of the providers believed that they could provide adequate care that would meet the needs of a transgender patient.

"With more transgender patients in the health care system, my findings identified that more research and more training is necessary to provide much needed, culturally competent care to transgender patients," Irwig said.

Irwig noted that even though some progress has been made in terms of treatment plans for transgender people, not much has been done to change the attitudes of the providers.

"The transgender community represents one of the most underserved and marginalized populations in health care," Irwig said. "It is therefore up to the physician population to become more familiar with their needs and train the next generation to be culturally competent and prepared to treat this growing community."

The Endocrine Society is currently updating its guidelines to help doctors improve how they care for transgender patients.

"The guidelines are an evidence-based, thoughtful approach from the ultimate mainstream endocrinology professional society and that is very strong for those needing reliable sources," said Dr. Josh Safer, who is working on the update.

The findings were published in the Feb. 29 of the journal Endocrine Practice.