To the Editor:
Over 11 million individuals in the U.S. self-identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+), a number roughly equivalent to the population of Ohio. 1 Yet, LGBTQ+ health topics are still not routinely taught in medical school curricula. The consequences of such omissions are clear: LGBTQ+ populations continue to face health disparities and report health care avoidance due to negative experiences and discrimination. 2 Systemic change is needed to create a safer and more inclusive environment for LGBTQ+ patients.
Trainees, especially those who identify as LGBTQ+, carry fresh perspectives informed by an evolving understanding of sexual and gender identity. As such, they are well positioned to improve LGBTQ+ care through clinical and educational initiatives.
As trainees, we have worked to create a more affirming environment for LGBTQ+ patients at our own institution. We started by procuring and distributing rainbow pins, personal pronoun badges, and inclusive signage in the hospital. Through the advocacy of our
predecessors, our medical center also recently incorporated sexual orientation and gender identity data into intake forms and the electronic health record—a crucial step toward ensuring that patients are properly identified.
Additionally, we collected survey data and identified opportunities to further integrate LGBTQ+ health concepts into our curriculum. For example, we collaborated with lecturers to incorporate more nuanced education on sex, gender, and sexual orientation into our clinical skills course. Our colleague Samantha Morris also designed a framework for taking an inclusive sexual history, which was subsequently adopted for our standardized patient encounter. Going forward, we are continuing to work with administrators to formalize longitudinal clinical experiences with LGBTQ+ populations.
Providing an inclusive environment for LGBTQ+ patients requires that institutions move from theoretical policies to concrete actions. Trainees can play a crucial role in this process, leveraging both their own experiences and the expertise of national networks (e.g., the Medical Student Pride Alliance). We encourage all trainees, whether they identify as LGBTQ+ or as allies, to use their voices to improve the health and well-being of all LGBTQ+ individuals.
The authors would like to thank Samantha Morris and Liam Spurr for their co-leadership on these efforts.
1. National Academies of Sciences, Engineering, and Medicine. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: National Academies Press; 2020.
2. Casey LS, Reisner SL, Findling MG, et al. Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans. Health Serv Res. 2019;54(suppl 2):1454–1466.