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Current training of physicians to care for LGBTQ individuals is falling short

March 15, 2019

(Boston)--Not enough is being done to prepare physicians to care for the needs of lesbian, gay, bisexual, transgender and queer (LGBTQ) patients. Better physician training on their unique clinical needs may eliminate many of the health disparities among this growing segment of the population according to a new study.

Approximately 3.8 percent of the U.S. population identifies as a sexual or gender minority (i.e. lesbian, gay, bisexual, transgender and/or queer). Many experience significant health issues often as a result of discrimination and harassment.

Compared to their heterosexual peers, lesbian and bisexual women have higher rates of heart disease as well as asthma and chronic obstructive pulmonary disease. Similarly, gay and bisexual men have an increased risk for cardiovascular disease when compared to their heterosexual peers. While cardiovascular health data remains mixed for transgender individuals for myocardial disease and stroke, transgender and non-binary individuals have significantly worse self-reported physical and mental health when compared to their cisgender peers.

In one of the largest studies of its kind, more than 800 first, second and third-year residents from 120 internal medicine residency programs completed a pre-test assessing their sexual and gender minority (SGM) knowledge. The residents then completed a one-hour online module reviewing diagnosis and management of SGM health, followed by a post-test. While all residents showed significant improvement between the pre-test and post-test scores, the year of resident training made no difference in the baselines pre-test scores. "Baseline knowledge of health issues of sexual and gender minorities, as assessed by pre-test performance, did not change as a result of residency training," explained lead author Carl Streed, Jr., MD, MPH, FACP, assistant professor of medicine at Boston University School of Medicine (BUSM). "This leads us to believe that there's a dearth of training in this area regardless of how many years a physician served as a resident."

While there are recommendations to prepare future physicians to care for LGBTQ individuals, the researchers believe current training is falling short. "There is no standard for training for physicians to prepare them to care for lesbian, gay, bisexual, transgender and queer patients. Training must include how to provide comprehensive and competent care for these patients and their families," added Streed, a physician at Boston Medical Center and the Center for Transgender Medicine & Surgery at BMC.

These findings appear in the Journal of General Internal Medicine.
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Boston University School of Medicine

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