Integrating LGBTQIA + Community Member Perspectives into Medical Education

Abstract

ProblemLGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and all sexual and gender minorities) people have unique health care needs related to their sexual orientation, gender identity and expression, and sex development. However, medical education has historically excluded LGBTQIA + health-related content in formal curricula. It is common for medical students to interact with diverse patient populations through clinical rotations; however, access to and knowledge about LGBTQIA + patients is inconsistently prioritized in medical schools. This is especially true for LGBTQIA + patients with intersecting historically marginalized identities, such as people of color and people with disabilities. Learning from and listening to medically underserved community members can help both medical students and educators better understand the unique health needs of these communities, and address implicit biases to improve health care and outcomes for their patients. Intervention: To address the lack of LGBTQIA + health-related content in medical education and improve access to and knowledge about LGBTQIA + patients, LGBTQIA + community members’ perspectives and lived experiences were integrated into undergraduate medical education via four primary methods: Community Advisory Groups, community panel events, standardized patients, and community member interviews. Context: LGBTQIA + community members’ perspectives and lived experiences were integrated into medical education at Harvard Medical School (HMS) as part of the HMS Sexual and Gender Minority Health Equity Initiative. Impact: LGBTQIA + community members’ perspectives and lived experiences were successfully integrated into multiple aspects of medical education at HMS. During this process, we navigated challenges in the following areas that can inform similar efforts at other institutions: representation of diverse identities and experiences, meeting and scheduling logistics, structural barriers in institutional processes, and implementation of community member recommendations. Lessons Learned: Based on our experiences, we offer recommendations for integrating LGBTQIA + community members’ perspectives into medical education. Engaging community members and integrating their perspectives into medical education will better enable medical educators at all institutions to teach students about the health care needs of LGBTQIA + communities, and better prepare medical students to provide affirming and effective care to their future patients, particularly those who are LGBTQIA+.

Keywords:

• Community
• differences of sex development
• intersectionality
• medical education
• sexual and gender minority

Acknowledgements

We would like to thank the HMS LGBTQIA + Young Adult Community Advisory Group, HMS LGBTQIA + Adult Community Advisory Group, and community members who participated as panelists in HMS LGBTQIA + community panels in 2020 and 2021 for sharing their time and lived expertise. We would also like to thank Jessica Halem for her integral contributions to the Initiative and Neeki Parsa for their help screening community advisory applicants and developing themes from community advisory group meetings.

Disclosure statement

Sabra Katz-Wise is a diversity consultant for McGraw Hill and Viacom/CBS. Jennifer Potter is a member of the PCORI Advisory Panel on Healthcare Delivery and Disparities Research. None of these companies or organizations provided funding for the Harvard Medical School Sexual and Gender Minority Health Equity Initiative. The other authors do not have any conflicts of interest to disclose.

Additional information

Funding

This project was funded by the Panjandrum Foundation.