Que(e) rying undergraduate medical curricula: a cross-sectional online survey of lesbian, gay, bisexual, transgender, and queer content inclusion in UK undergraduate medical education

Tollemache, Nicholas; Shrewsbury, Duncan; Llewellyn, Carrie

doi:10.1186/s12909-021-02532-y

Cited by 43 publications

(59 citation statements)

References 18 publications

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“…When ‘queer’ is used in post-graduate and graduate medical education research, it refers to curriculum gaps, patient identities in relation to culturally safe care and physician competencies, and the experiences of LGBT+-students (Baker & Beagan, 2014 ; Donald et al, 2017 ; MacCormick & George, 2020 ; Muntinga et al, 2020 ; Streed et al, 2019 ; Tollemache et al, 2021 ). Applying a queer lens to medical education has led authors to suggest the existence of a global discursive and systemic invisibility of queer narratives and needs, and a widespread refusal to label sexual and gender minority status as medically significant – a situation Müller ( 2018 ) identifies as an active process of erasure.…”

Section: Introductionmentioning

confidence: 99%

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Heesewijk

Kent

Grift

et al. 2022

Adv in Health Sci Educ

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Health disparities faced by transgender people are partly explained by barriers to trans-inclusive healthcare, which in turn are linked to a lack of transgender health education in medical school curricula. We carried out a theory-driven systematic review with the aim to (1) provide an overview of key characteristics of training initiatives and pedagogical features, and (2) analyze barriers and facilitators to implementing this training in medical education. We used queer theory to contextualize our findings. We searched the PubMed/Ovid MEDLINE database (October 2009 to December 2021) for original studies that reported on transgender content within medical schools and residency programs (N = 46). We performed a thematic analysis to identify training characteristics, pedagogical features, barriers and facilitators. Most training consisted of single-session interventions, with varying modes of delivery. Most interventions were facilitated by instructors with a range of professional experience and half covered general LGBT+-content. Thematic analysis highlighted barriers including lack of educational materials, lack of faculty expertise, time/costs constraints, and challenges in recruiting and compensating transgender guest speakers. Facilitators included scaffolding learning throughout the curriculum, drawing on expertise of transgender people and engaging learners in skills-based training. Sustainable implementation of transgender-health objectives in medical education faces persistent institutional barriers. These barriers are rooted in normative biases inherent to biomedical knowledge production, and an understanding of categories of sex and gender as uncomplicated. Medical schools should facilitate trans-inclusive educational strategies to combat transgender-health inequities, which should include a critical stance toward binary conceptualizations of sex and gender throughout the curriculum.

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Section: Introductionmentioning

confidence: 99%

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Heesewijk

Kent

Grift

et al. 2022

Adv in Health Sci Educ

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“…Numerous studies have documented a continued gap in content specific to lesbian, gay, bisexual, trans, and queer (LGBTQ) content in healthcare education [ 23 – 28 ]. Providing gender-affirming care is more than the absence of anti-trans stigma and encompasses more than providing medical transition-related care.…”

Section: Introductionmentioning

confidence: 99%

Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

et al. 2021

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Background Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’. This theoretically-informed community-developed intervention aimed to increase providers’ gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV. Methods Healthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons. Results The intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12–10.86, p < 0.001, possible score range: 16–96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90–4.90, p < 0.001, possible score range: 9–63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training. Conclusions This brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women. Trial registration ClinicalTrials.gov (NCT04096053).

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“…Additionally, there are universities in the USA and Canada that include updated and expanded curriculum on the care of transgender populations in their undergraduate and graduate medicine programs [ 45 , 47 – 50 ]. In the UK, University College London and Bristol Medical School have implemented sessions to raise awareness of SGM health inequalities [ 51 ]. In Israel, the Tel Aviv University includes transgender care in its obstetricians/gynecologists continuing medical education training [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Transgender men's preferences when choosing obstetricians and gynecologists

Lifshitz

Yaish

Wagner-Kolasko

et al. 2022

Isr J Health Policy Res

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Background Transgender men are a marginalized population with unique health care needs. However, their usage of health services is low because of considerable discrimination. A major factor in their avoidance is patient-provider interactions. Methods This cross-sectional study included 102 transgender men who anonymously completed a 55-item questionnaire in clinic, between 10/2017 and 01/2019. In addition, 92 transgender women filled out the part about family physician’s preferences. We examined which characteristics transgender men prefer in their obstetricians/gynecologists in order to promote their usage of healthcare services. Results A small majority of the transgender men (54.1%) had no gender preference for their obstetrician/gynecologist, while 42.9% preferred a female obstetrician/gynecologist and 3.1% preferred a male obstetrician/gynecologist. Most transgender men with a same-gender preference preferred female obstetricians/gynecologists for both invasive procedures (e.g., pelvic examination, 97.4%) and non-invasive procedures (e.g., cesarean section, 60%). The reasons for preferences regarding invasive procedures were feeling comfortable, embarrassment and feeling that female obstetricians/gynecologists are gentler. Transgender men who preferred female obstetricians/gynecologists ranked ability (90.5%), sexual tolerance (92.9%) and gender identity tolerance (90.5%) as the top three desirable qualities of obstetricians/gynecologists, while the responders who did not prefer female ranked ability (94.6%), experience (92.9%) and knowledge (92.9%) as the top three qualities. Transgender men with female preferences considered female obstetricians/gynecologists to be more accepting of gender identity compared to the responders that did not prefer females (47.5% vs. 9.1%, P < .001).. Conclusion A small majority of the transgender men exhibited no gender preference when choosing an obstetrician/gynecologist, although 42.9% preferred females. The latter choice was associated with the assumption that female obstetricians/gynecologists are more tolerant towards their transgender men patients. Educating the medical staff about their special needs and establishing dedicated SGM centers staffed with high percentages of female healthcare providers are highly recommended.

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Que(e) rying undergraduate medical curricula: a cross-sectional online survey of lesbian, gay, bisexual, transgender, and queer content inclusion in UK undergraduate medical education

Cited by 43 publications

References 18 publications

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators

Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

Transgender men's preferences when choosing obstetricians and gynecologists

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