LAUSR

Medical schools in the USA and Canada report that a small amount of time is dedicated in undergraduate medical education to topics related to patients who are lesbian, gay, bisexual, transgender, or queer (LGBTQ), despite recent data that show medical students who have clinical encounters with LGBTQ patients not only had a more positive attitude toward this subset of the population but also were able to perform a more complete patient history [1, 2]. Medical students at a large west coast university were evaluated for preparedness and comfort when working with LGBTQ patients, and the study found that 67% of students ranked their LGBTQ medical curriculum as “fair or worse,” and most (70%+) did not feel comfortable discussing gender-affirming surgery and gender transitioning [3]. A study done at another university showed that medical students felt unprepared to attain a comprehensive sexual history that was inclusive of patients in the LGBTQ community and did not feel prepared to provide appropriate counseling [4]. This research reveals a need for medical students to gain readiness, knowledge, and greater experience in their medical training as it pertains to the LGBTQ community. In addition to the need, there is also a desire for advanced LGBTQ education found by medical students across the USA [5]. A recent survey indicated that only about 50% of participating primary care providers felt that they were competent in providing LGBTQ care [6]. The literature shows that physicians do not routinely assess sexual history in general during patient encounters and that some physicians may be afraid of offending their patients or losing their trust and therefore do not ask important questions surrounding gender identity and sexual orientation [7, 8]. This gap in physician competency may lead to decreased utilization of healthcare by LGBTQ individuals and may worsen various health disparities that exist among this population, as seen in one such survey which showed that transgender and gender nonconforming students reported significantly lower health and lower rates of preventative checkups [9]. Early integration of LGBTQ curriculum and patient exposure may reduce the risk of adverse health outcomes within this community. From the perspective of a public health practitioner (KO) and fourth-year medical student (KO) interested in working with minority populations such as the transgender population, it seems evident that exposure and education during medical school are key to breaching boundaries surrounding successful patient outcomes.