LGBTQ+ health education for medical students in the United States: a narrative literature review

Abstract

Introduction People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development. Methods PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011–6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes. Results One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions. Conclusion Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.

Sexual and gender minority content in undergraduate medical education in the United States and Canada: current state and changes since 2011

“…UME has included sparse instruction in LGBTQI + health-related content [ 12 ]. The 2011 study of US and Canadian allopathic and osteopathic medical schools by Obedin-Maliver et al .…”

“…Further, inclusion of validated measures of LGBTQI + competency in the assessment of graduates’ knowledge and preparedness to care for LGBTQI + persons would improve the evaluation and development of curricular interventions. A 2024 narrative review of LGBTQI + undergraduate medical education in the United States found multiple studies noting that students receive inadequate education, especially in their knowledge and preparedness to care for LGBTQI + patients, particularly transgender and gender diverse patients [ 12 ].…”

Who needs education on LGBTQIA+ healthcare inclusion?

“…We read with great interest the work by Tess I. Jewell and Elizabeth M. Petty on LGBTQIA+ health education for medical students in the United States [ 1 ].…”

“…This interesting work analyzes the training needs of medical students [ 1 ]. The literature also provides abundant evidence of the training and refresher needs on these topics for already trained doctors and specialists.…”