Medical Schools Not So Great At Teaching About Gay People

Having to explain Sex and Gender 101 to your health provider is an annoying and distressing part of visiting the doctor for many LGBTQ patients.   In May Riese reported on this awkwardness and the landmark health education reforms at NYC’s Bellevue Hospital using the training video, “To Treat Me, You Have to Know Who I Am: Welcoming Lesbian, Gay, Bisexual and Transgender Patients into Healthcare” with the help of The National LGBT Cancer Network. While it’s certainly refreshing to know NYC is making these moves, a report published in the current issue of the  Journal of the American Medical Association shows there is a long way to go in assuring that med students receive quality LGBTQ curriculum as part of their medical education.

 

GAY PEOPLE???

The findings of the recently published report demonstrate that LGBT curriculum for many med schools is still fairly pathetic. Conducted by Stanford University’s LGBT Medical Education Research Group, the study asked deans to answer a 13 question web-based questionnaire assessing LGBTQ curriculum at their institution.

The disappointing results of the survey of 150 programs found that on average med schools teach about five hours of LGBT related content, and some even reported teaching absolutely none. The quality of the content of the programs varied widely, and at 58 (out of 176) of those schools it only qualified as “fair.”

While the study did find students are increasingly being taught to ask if patients sleep with men, women, or both, understanding the difference between sexual behavior and identity is a different issue. Having to clarify the differences to a bewildered health-care provider is awkward enough, but there are many other issues at hand when it comes to poor education in LGBTQ curriculum. CNN’s blog The Chart explains:

Higher rates of anxiety, depression, suicidal thoughts, smoking, alcohol consumption, substance use, youth homelessness, harassment, sexually transmitted infections, and HIV/AIDS all affect the LGBT community, studies show.In addition to persistent social stigma, there are structural barriers to health care access among the LGBT community, such as partners not qualifying for employer-sponsored health care coverage.

Even if your health care provider happens to be one of those who’s been trained to ask about your identity, that doesn’t mean they have any idea that there are specific health concerns that go along with it. And effective, safe medical care for trans* people can be even harder to come by; it can be difficult to find even find a provider who doesn’t characterize your body and identity as disordered, let alone know how to treat you. And so it looks like for now we will have to continue doing the education in the doctor’s office or seeking out providers through the Gay & Lesbian Medical Association. At least these doctors get it!

Some educators have pointed out that in a study such as this it’s hard to account for what other environmental factors may inform med students about LGBTQ issues from a broader context on campus and their own lived experience. Nevertheless, it’s hard to deny the results of this survey pointing to an need for increased attention paid to the topic to assure improved healthcare for the LGBTQ community.

Jamie lives in Boston and is currently a PhD student in Global Governance and Human Security at the University of Massachusetts Boston. She is a freelance writer and also a team associate for the Boston chapter of Hollaback!.

Jamie has written 79 articles for us.

21 Comments

  1. This is a really important issue! One that definitely does not get enough attention. Though, I must exclaim that Ithaca College’s (whoo!) health center physicians ask students who they sleep with, and provide accurate information about keeping themselves safe. Colleges should definitely be asking their students who come in for medical assistance about their sexual preferences in addition to all physicians.

  2. For a group that just wants to be accepted and treated like everyone else, they sure go out of their way to make themselves seem different. I don’t see why doctors need any special education here. If there’s a physical or mental problem, you treat it. It doesn’t matter how it happened. If someone has HIV, is there a different treatment if you’re gay? I don’t think so!

  3. @CB: Yeah, I really *try* to experience homophobia at the doctor’s. My boyfriend really encourages those shocked looks and insulting comments he gets when they find out he’s trans. pfft

    I’ve noticed (through negative experience) that not only is basic LGBT health not well covered at many med schools, but people graduate from such institutions without knowledge of the very existence of LGBT people. Brilliant.

    I wrote a diatribe about my various medical adventures: http://theczech.wordpress.com/2009/08/02/adventures-in-medicine/

    If you don’t want to read it all, the most LGBT-relevant part is in the section called “Medical Adventure II, the sequel”.

  4. Pingback: Med Schools Fall Short On LGBT Education – NPR (blog) | Live Newsline

  5. In defense of medical schools, 5 hours of training isn’t quite as bad as it sounds, especially if it is 5 hours of training specifically dedicated to the topic. That’s about what we had at my medical school, and it’s more training than we have on most other subjects, be they strictly medical (eg gallstones) or more cultural (eg patient literacy). There are a lot of topics to cover so most are covered in a single hour of dedicated teaching. (I make no excuses for med schools that offer no LGBT curriculum whatsoever – that’s ridiculous).

    Much of what is learned in medical school comes not from dedicated teaching but rather from just “picking things up” on the wards, and here it is really the culture of the institution and how individual physicians handle LGBT patients that matters a lot more than any specific curriculum. Unfortunately, that is inherently more difficult to assess in a survey.

  6. My medical school does not offer any lectures/seminars/etc on LGBT health and issues. It is really a disgrace. We even have doctors who are still quite discriminatory towards LGBT people.

    Once we were treating a woman who was a lesbian with social problems and was not properly treating her asthma. When she left the room the doctor remarked her likely homosexuality based upon her appearance and that she wore men’s underwear to be probably the major reason for her lack of compliance with taking her medication. He called her a “poor thing” because she is gay.
    I must be honest and remark that I did not say a word and defend her in any way. I do not appear particularly gay from my appearance. And I even think some doctors find it absurd to even think of the notion of a lesbian medical student/doctor.

  7. My nursing school mostly just mentioned that gay people exist. And then hinted that it was not the nurses place to judge. (then later there was a slightly snide remark about AIDs.) Oh healthcare, I will do my part in changing you.

    • That sounds about like my nursing program. We had one instructor who mentioned gay men, but that was it. I’m doing my part – especially in the message boards for my community health class!

  8. During my first year of med school some people actually got to practice doing a sexual history on a standardized patient who was supposed to be a lesbian. While there is still a LOT of work to be done, some schools (even the Catholic one I was at!) actually are trying to cover LGBT issues. But as the article stated, most students still don’t know what to do with the information they gather. By the end of the exercise, most of my classmates still didn’t understand how lesbians can get STIs. At one point the patient actually said “what, do you want me to explain to you how lesbian sex works?” I honestly think that would have been useful for many of them…

  9. We definitely need more teaching about LGBT issues in my medical school. Taking practice sexual histories the other day, some of my classmates though being gay was the most hilarious thing ever…
    You would think some of this would just be common sense, but some people just don’t seem to have too much of that, unfortunately.

  10. Man, I go to med school in the Philippines… where lesbians don’t “exist” apparently. I also went to nursing school out here as well and nothing about LGBT issues came up even though everyone wants to work in the US or elsewhere, so I’m pretty sure my uberCatholic med school won’t touch on how to treat LGBT patients.

    But silver lining I suppose is that half of the comments on here are from future doctors and nurses.

  11. So excited I’m going to the MN Trans Health and Wellness Conference this weekeeeeeeend, and I have looked over the list and intend to hit up all of the workshops focusing on how to make your clinic/practice trans* and non-gender-conforming friendly! I am particularly excited about one that is specific to non-gender-conforming, because that’s been the hardest one for me to deprogram. So much of it is in the daily language I use, and it’s frustrating to realize it =/

  12. (I am not trying to be or sound like a troll)

    What disease can a lesbian get that a straight woman can’t? None (to my knowledge).

    What disease can a straight woman get that a lesbian can’t?
    Again, none (to my knowledge).

    The only thing that is different is disease rates…BUT even those women who are not sexually active should get a pap smear every few years because cervical cancer isn’t always caused by HPV or other hormonal conditions can be spotted…

    (Someone who is trans and is/has undergoing hormonal therapy or surgery I am excluding because either of those things can really change someone’s body and may cause other issues…)

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