America’s Inadequate LGBT Medical Education: A Challenge to Our Institutions

Curved library shelves and windows.

Reposted with modifications from the original article on KevinMD.

Medical students are asked to learn in exquisite detail the ins and outs of rare diseases that may never be encountered in clinical practice. Yet the education we receive on caring for a population numbering in the millions is sorely lacking, and the health of those patients—the members of our communities identifying as lesbian, gay, bisexual, transgender, or as another sexual or gender minority—is suffering as a result.

Data is dishearteningly sparse concerning health disparities among LGBT individuals, driven in large part by researchers failing to collect sexual preference data on medical study participants. Even so, we know that health outcomes are almost uniformly worse among this group and the diverse communities it encompasses. This is true of modifiable risk factors for cardiovascular disease, prevalence of obesity and type 2 diabetes, risk of mortality from breast cancer, use of tobacco and other harmful substances, sexually transmitted infections, suicidal ideation and suicidality, and more.

Some of these health disparities are known to the average medical student or practitioner—increased rates of STIs and suicidality among certain LGBT communities, for instance. Some are not. All require population-specific training in order to effectively treat and counsel patients regarding the factors influencing these outcomes. Yet medical students consistently report that they lack adequate training in caring for LGBT patients and believe additional medical education in this area makes them “more prepared” in the clinic.

Noting these deficiencies in our undergraduate medical training, a recent NPR feature highlighted several medical students’ efforts to push for more LGBT health education in their own institutions’ curricula.

This should not be necessary.

The task of buttressing the shortcomings of our country’s LGBT health care education should not fall to medical students. The job of students is to learn—not teach, not design curricula. More than that, student-led efforts to change medical education are sporadic, overly reliant on extraordinary student engagement, and at constant risk of being lost to follow-up as students enter their clinical years and ultimately graduate.

We know our LGBT patients have unique health care needs and poorer health outcomes compared to the population at large. It is incumbent on those whose job it is to design and accredit our nation’s medical school curricula to ensure that our future physicians learn how to provide excellent health care to the more than eight million people in this country who identify as LGBT.

Haidn Foster

Haidn Foster is President and Editor-in-Chief of Pride in Practice. He is a Medical Student Scholar in Neuroscience at the University of Cincinnati College of Medicine.

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