Epistemic Peerhood as a Model To Improve Gender-Affirming Care in Medical Education

Abstract

Issue: Inadequate training around gender-affirming care is a critical gap in health care and medical education that causes disparities and leads to injury for transgender, nonbinary, and other gender-diverse patients. In contrast to this widespread provider knowledge gap, gender-diverse patients bring critical knowledge from their own experiences to health care. Embracing varied epistemologies, or sources of knowledge, within medical education has the potential to enhance gender-affirming care by intentionally placing value on the lived experiences and emphasizing the credibility of gender-diverse patients. Evidence: In this article, the authors endorse a model of epistemic peerhood in which the embodied knowledge of gender-diverse patients and the authoritative knowledge of providers are each valued for their contribution to care. The authors reflect on experiences developing gender-affirming healthcare curricula and how medical education has not yet adequately addressed gender-diverse care without embracing community knowledge. Implications: The authors identify three vital areas to integrate epistemic peerhood in medical training to address gaps in gender-affirming care: (1) collaborative student training methods that reflect embodied knowledge in the absence of, or in addition to, clinical expertise on gender-affirming care; (2) sustainable partnerships between academic programs and gender-diverse communities that foster continuous engagement from collaborators with lived experience; and (3) broad community input about best practices for representing gender diversity in patient simulation. Embracing epistemic peerhood in each of these areas would result in broader gender-diverse community representation and leadership in medical education, which would ultimately strengthen gender-affirming healthcare training.

Keywords:

• Transgender health
• gender minority
• community engagement
• patient simulation
• epistemology

Acknowledgements

The research team would like to thank the LGBTQ+ community members who contributed their time and expertise to help improve medical education. The authors also thank the University of Louisville LGBT Center, School of Medicine, and School of Public Health & Information Sciences for their support in our ongoing efforts to address LGBTQ health disparities.

Disclosure statement

We have no conflicts of interests to report.

Funding

No grant funding was used to support this research.

Data availability statement

Data not available due to ethical restrictions. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.