LAUSR

The term “sexual minorities” refers to a broad and diverse community of individuals who do not conform to normative standards for sexual orientation, gender identity, or sexual practice; these individuals are often grouped under the term LGBT (lesbian, gay, bisexual, or transgender). Numerous studies have found that LGBT individuals demonstrate unique patterns of mental health issues, including increased rates of suicidal behavior, substance use disorders, and mood and anxiety disorders compared with non-LGBT peers [1]. Stigma, victimization, exclusion, and perceived discrimination are thought to contribute to the increased rates of mental health conditions among LGBT populations [2], and, in turn, perceived discrimination may reduce help-seeking behavior among these individuals [3]. Therefore, there is a pressing need to train future psychiatrists to recognize and address mental health issues in their LGBT patients, while creating a welcoming environment for them. The current state of adult psychiatry residency LGBTspecific training is not well documented. The Accreditation Council for Graduate Medical Education (ACGME) Program Requirements in Psychiatry specify that residents should gain competence in medical knowledge and professionalism related to “sexual orientation” [4]. However, the ACGME does not delineate how training programs are to achieve those goals. A recent survey of program directors and trainees within 19 adult and child-psychiatry New York City-based training programs revealed that 42.4% of respondents reported no coverage of LGBT-specific topics, though 89.9% of trainees and 62.5% of program directors expressed interest in hearing from guest speakers about such issues [5]. Here, we describe the development and early implementation of an LGBT “area-of-distinction” (AoD) within an adult psychiatry residency program. We anticipate that this narrative (and supplemental material, available upon request) will serve as a resource for training program leaders who are considering ways to integrate LGBT-specific education into their curricula.