Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies

Abstract

Introduction

Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals.

Methods

A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis.

Results

Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development.

Discussion

Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.

Keywords:

• Gender nonconforming
• healthcare
• medical education
• medical students
• professional identity

Acknowledgement

The authors acknowledge the contributions of Kyle Robertson, MS, for editorial advice.

Ethical approval

The study protocol was reviewed as an exempt protocol by the Indiana University Institutional Review Board (protocol #2003666882) and by the Purdue University Institutional Review Board (protocol #2020-369).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

The authors did not receive funds, grants, or other support for the submitted work.

Notes on contributors

Julianne Stout

Julianne Stout, MD, MBA, is a Clinical Associate Professor of Medicine, Veterinary Administration Department, Purdue University and an Adjunct Clinical Associate Professor of Medicine and Pediatrics, Indiana University School of Medicine-West Lafayette, West Lafayette, IN, USA.

Aletha Stahl

Aletha Stahl, PhD, is a Senior Intercultural Learning Specialist, Center for Intercultural Learning, Mentorship, Assessment and Research, Purdue University, West Lafayette, IN, USA.

J. Dennis Fortenberry

J. Dennis Fortenberry, MD, MS, holds the Donald Orr, M.D. Professorship of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.