Assessing Medical Students’ Attitudes and Knowledge Regarding LGBTQ Health Needs Across the United States

Abstract

Background: The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community experiences health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ community. The objective of this study was to identify gaps in knowledge and comfort among medical school students in providing care for the LGBTQ community. Methods: An online survey was administered to medical students at 3 institutions in the United States from December 2020 to March 2021. Using a Likert scale, the survey assessed attitudes, comfort, and knowledge in providing care for the LGBTQ community. The survey included questions for each specific LGBTQ population. Results were quantified using descriptive and stratified analyses, and an exploratory factor analysis was used to calculate attitude summary measure (ASM) scores. A total knowledge score was calculated, with higher values indicating greater knowledge. Results: Among the 300 medical students who completed the survey, the majority were female (55.7%), White (54.7%), and heterosexual (64.3%). The majority of medical students felt comfortable (strongly agree/agree) participating in the care of lesbian (94.3%), gay (96.0%), and bisexual (96.3%) patients; this percentage dropped to 82.3% for non-binary and 71.3% for transgender patients. Only 27.0% of medical students reported confidence in their knowledge of health needs of transgender patients. LGBTQ self-identification, percent of core rotations completed in school, region of country, and friends and/or family who are part of the LGBTQ community were significantly associated with various ASM scores. Knowledge questions yielded high percentages of “neutral” responses, and medical students who identified as LGBTQ had significantly higher total knowledge scores. Conclusions: Overall, the surveyed medical students feel comfortable and willing to provide care for LGBTQ persons. But, there is limited knowledge about specific LGBTQ health needs. More education and training in the needs of transgender and non-binary patients, in particular, is indicated.

Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender‐nonconforming

“…One survey of medical students found that 95% were comfortable caring for lesbian, gay, or bisexual patients, but only 70% were comfortable caring for transgender patients, and only one in four was confident regarding the health needs of transgender patients. 107 More concerning, among oncologists working at National Cancer Institute-designated Comprehensive Cancer Centers, less than 40% were confident in their knowledge of the health needs of transgender individuals. 108 Inclusion of transgender health in medical and nursing school curricula and continuing education is a crucial step toward improving care for transgender individuals with cancer.…”

Communicating with LGBTQ+ persons at end of life: A case‐based analysis of interdisciplinary palliative clinician perspectives

“…LGBTQ þ patients and express a desire for education about optimal approaches to ensure respectful care. [17][18][19][20][21] Several communication and related cultural competency…”

“…LGBTQ + communicative competence is comprised of knowledge about LGBTQ + issues, understanding of appropriate vocabulary, reconciling of personal beliefs within the context of professional roles and responsibilities, creation of an inclusive care environment, and use of patient‐requested identifiers 16 . However, interdisciplinary health professionals and trainees consistently demonstrate limited knowledge regarding optimal communication strategies when caring for LGBTQ + patients and express a desire for education about optimal approaches to ensure respectful care 17–21 …”