Are Medical Students More Prejudiced? Comparison of University Students’ Attitudes Towards Sexual Minorities by Faculties and Cultural background: A Study From Hungary

ABSTRACT

Sexual and gender minorities often experience discrimination or stigmatization during health encounters. When patients feel stigmatized, they are more likely to delay seeking help and it affects patient cooperation and compliance, thus undermining therapeutic efficacy itself. We examined knowledge and attitude toward LGBT+ people among Hungarian (n = 743) and foreign (n = 130) medical students of the four Hungarian medical universities and 188 students from other faculties. Homonegativity and inadequate knowledge about sexual minority individuals are correlated with male gender, conservative political views, religiosity, religious behavior, and the absence of LGBT+ acquaintance. Medical students show more negative attitudes than students from other disciplines, although foreign medical students were more accepting than Hungarian program students. Further investigation of sexual minority-related content of the Hungarian medical education and revising the written and hidden curriculum would be desired, as well as collecting data from postgraduate students, physicians, and wide range of university faculties.

KEYWORDS:

• Medical students
• university students
• attitude
• sexual minorities
• LGBT
• cultural competence
• homonegativity

Disclosure statement

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

Data availability statement

The data that support the findings of this study are available from the corresponding author, ZT, upon reasonable request.

Notes

1. We used both the MHS-G and MHS-L scales in order to compare the attitudes toward lesbian women and gay men. For practical reasons, we used only one of our student subgroups (students of the Semmelweis University) for this purpose and distributed among them the MHS-G and MHS-L versions randomly.

2. The HPATSM score is comprised of 14 items for which Cronbach’s alpha is 0.87, and the intraclass correlation coefficient [ICC(1,k)] is 0.832. Looking at the squared multiple correlation coefficients of each item with all others, the values are around 30–60%. Item number 8, “The state funded health insurance should finance the sex reassignment surgery of transsexual persons.” is an outlier with a value of only 5.6%. If left out, Cronbach’s α increases to 0.89. A confirmatory factor analysis (CFA) for a single underlying HPATSM factor gives adequate results (Table 6). The fit indices show moderately good fit. The Root Mean Square Error of Approximation (RMSEA) is 0.089, the Comparative Fit Index (CFI) is 0.898, and the Tucker-Lewis Index (TLI) is 0.880. When item 8 is excluded from the analysis, the CFI increases to 0.903, and the TLI to 0.883.

Table 6. Standardized coefficients for the confirmatory factor analysis.

The HPATSM scale has a unidimensional structure and possesses an adequate level of reliability. It is highly correlated with both MHS and ATLG and shows the strongest relationship with KAH among the measured scores. The qualitative similarity between the coefficients of the regression models for HPATSM and MHS-G validates the former and corroborates the similarity seen from the bivariate correlation with the latter. As evidence of construct validity, scores on the HPATSM scale correlated positively both with modern and old-fashioned homonegativity (MHS-G score: r(583) = 0.67, p < ,0001; MHS-L score: r(160) = 0.50, p < ,0001; ATLG score r(657) = 0.63, p < ,0001) (Table 7).

Table 7. Correlations between attitude and knowledge scales.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.