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To characterize transgender healthcare training during OB/GYN residency.Professional medical organizations increasingly recognize the importance of transgender healthcare, but the training currently offered in OB/GYN residencies is not well understood.We conducted a cross-sectional survey of a regionally representative random sample of 100 from 236 OB/GYN residency program directors between August 2016 and June 2017. Questions addressed demographics, presence and type of resident transgender healthcare training. We compared attitudes, barriers and facilitators between programs that did and did not offer transgender healthcare training using chi-squared testing.Among 61 responding program directors, 50.8% (N=31) reported offering transgender healthcare training, Region of country, program type and size did not differ between those offering and not offering training. Of those offering clinical training in transgender healthcare, 41.9% did so in generalist and 22.6% in specialist OBGYN clinics, 32.3% provided hormone therapy, and 16.1% learned about gender reassignment surgery techniques. Programs offering training were more likely to report a transgender community requesting services (90.3% versus 53.3%, P=.001), interested faculty (45.2% versus 20.0%, P=.03), time allotted for training (29.0% versus 0%, P=.001) and resident interest (64.5% versus 36.7%, P=.03). The most significant barrier to providing training was lack of interested faculty, reported by 73.3% of programs that did not versus 38.7% that did offer training (P=.006).Only half of responding residency programs offer transgender healthcare training. CREOG named transgender healthcare an educational objective in 2013 and should support this by identifying interested faculty and resident champions who can lead implementation at all OB/GYN residency programs.