LGBTQ Health Education: Where Are We Now?

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Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients have unique health care needs that our medical system must strive to address. In August 2016, the U.S. Centers for Disease Control and Prevention released an alarming report demonstrating that youth who identify as lesbian, gay, or bisexual, when compared with their heterosexual peers, are significantly more likely to report increased rates of bullying and sexual and physical violence, placing them at risk for suicide, depression, substance use, and poor academic performance.1 Moreover, this population continues to face barriers to utilization of care due to fear of stigmatization, provider bias or outright discrimination, and decreased access to insurance. Although the Affordable Care Act has improved insurance coverage for an as-yet undetermined number of LGBTQ patients, I am concerned about how the medical education system will be preparing tomorrow’s physicians to manage topics such as gender transitioning, mental and behavioral health, and sexual health.
Currently, there are no requirements from the Accreditation Council for Graduate Medical Education that medical schools or residency programs must devote curriculum hours to LGBTQ health care, and historically there have been no formal education standards on this topic for these institutions to follow. As a sign that greater emphasis is being placed on medical education, in 2014 the Association of American Medical Colleges published recommendations encouraging inclusion of LGBTQ curriculum requirements in medical school.2 Similarly, the American Academy of Family Physicians in conjunction with the Society of Teachers of Family Medicine published recommendations in 2013 for incorporation of a formal curriculum for LGBTQ issues in family medicine residency programs.3 However, it is unclear if or how widely these have been incorporated.
As a medical student I received no formal education regarding LGBTQ health care. As a family medicine resident I worry that tomorrow’s physicians will not practice with the knowledge to provide culturally competent and appropriate medical care to these patient populations in hopes of reducing these health care disparities.
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