Is the Lack of Specific Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students

Abstract

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons' health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (r = 0.5052, p < .01). Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

“…10,14,15 With regard to education, especially in the context of principles of adult learning, existing studies call for developing competencies that encompass critical knowledge, skills and attitudes needed to provide affirmative care to LGBT people. [4][5][6][7][8]11 These cannot be measured in hours, but through comfort with effective communication and patient satisfaction. A curricular resource with suggested milestones has been developed by the Association of American Medical Colleges that can serve as a guide for educational programs seeking to expand LGBT health training.…”

“…4,5 As recently as a decade ago there were no standard texts that included information about care for LGBT people, and numerous studies and reviews of health issues have documented a continued gap in health care education. [4][5][6][7] A study of LGBT topics in medical education published in 2011 showed a median of 5 h of education in both the US and Canada. 8 It is not surprising that despite demonstration of health disparities experienced by LGBT people across the life cycle, many LGBT people find it difficult to access quality care.…”

The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review

“…It has become clear, through this review, that issues exist around the development of cultural competence to enable practitioners to deliver care and supports in culturally responsive, sensitive and inclusive ways (Corliss et al, 2007;Fredriksen-Goldsen et al, 2011;Carabez et al, 2015b;Chen and Yang, 2015;Walsh and Hendrickson, 2015;Echezona-Johnson, 2017;Parameshwaran et al, 2017). In one UK study involving medical students, where almost 85% of participants reported a distinct lack of LGBT+ education, nearly half said that they would not routinely ask about sexuality or gender identity needs when assessing patients.…”

“…A score of zero was given if the paper contained no information, one if there was a moderate amount, and a score of two if the question was fully addressed (Rushbrooke et al, 2014). A total of 13 studies scored 17 and above (Bidell, 2017;Carabez et al, 2015b;Daley and MacDonnell, 2015;Echezona-Johnson, 2017;Grosz et al, 2017;Kelley et al, 2008;Lim et al, 2015;Obedin-Maliver et al, 2011;Parameshwaran et al, 2017;Rogers et al, 2013;Strong and Folse, 2014;Walsh and Hendrickson, 2015;White et al, 2015). A total of 9 studies scored between 14 and 16, indicating gaps and limitations in relation to aims, data collection methods, and ethical concerns (Carabez et al, 2015a;Cheng & Yang 2015;Corliss et al, 2007;Fredriksen-Goldsen et al, 2011;Gendron et al, 2013;Hardacker et al, 2014;Röndahl, 2011;Sequeira et al, 2012;Vance et al, 2017).…”

“…In one UK study involving medical students, where almost 85% of participants reported a distinct lack of LGBT+ education, nearly half said that they would not routinely ask about sexuality or gender identity needs when assessing patients. Students admitted feeling a lack of confidence and poorly prepared regarding LGBT+-specific health care terminology and this may lead to miscommunication and potential shortcomings in the provision of adequate health and social care (Parameshwaran et al, 2017). Some education programmes, identified in this review, had attempted to embed suitable LGBT+ content into their curricula, however with varying levels of success.…”