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.

KEYWORDS:

• Medical student
• LGBTQ+
• sexual and gender minorities
• curriculum
• medical education
• LGBT health

Acknowledgments

The authors would like to thank senior academic librarian Mary Hitchcock for her guidance and assistance in developing and executing the database searches for this project. We would also like to thank all of the community members, students, staff, and faculty who have and continue to contribute to the growing body of knowledge on LGBTQ+ health in medical education. We also thank the Kern National Network funded by the Kern Family Foundation that provided partial salary support for one of the authors (EMP) during the time of this study.

Declarations of interest

The authors have no conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Both authors conceived and designed the review. TIJ conducted the literature screening and analysis, based on an approach for screening and analysis as determined by both authors. EMP reviewed the analysis and areas of uncertainty were clarified through reaching consensus in discussions between both authors. TIJ wrote the first draft of the manuscript. EMP reviewed the draft and provided feedback. Both authors collaborated on editing and finalizing the manuscript. Both authors reviewed and approved the final article, including all submitted tables, figures, and appendix.

Additional information

Funding

One of the authors (EMP) received partial salary support from the Kern National Network funded by the Kern Family Foundation during the time of this study.