A recent study published in the Journal of the American Medical Association shows that doctors are not being trained to ask the right questions of LGBT patients. The study reported on the results of research associated with the Lesbian, Gay, Bisexual and Transgender Medical Education Research Group at Stanford University School of Medicine. The study was covered recently in the New York Times.
Medical school deans in the United States and Canada were asked about the curriculum and specifically about whether and how medical students are trained to address with patients such topics as gender identity, coming out as gay and disparities in health care access for lesbian, gay, bisexual and transgender patients.
While nearly all the students were learning to ask patients about the gender of their sexual partners, a majority of medical schools devoted only five hours to teaching anything more than that simple question.
Fully one-third of schools allotted no time at all.
“These results should serve as a call to action for the health profession to include L.G.B.T. health as part of the standard curriculum,” said Dr. Desiray Bailey, in the New York Times article. Bailey, an anesthesiologist, spoke as president of the Gay and Lesbian Medical Association.
Another report, this one by the Institute of Medicine, concluded that L.G.B.T. patients are likely to have higher rates of chronic diseases, such as diabetes and high blood pressure.
A serious related problem, according to the Times article is that "organizations responsible for accrediting medical schools and licensing physicians do not require that prospective doctors know about health care issues for lesbian, gay, bisexual or transgender patients."
“These results should serve as a call to action for the health profession to include L.G.B.T. health as part of the standard curriculum,” said Dr. Desiray Bailey, in the New York Times article. Bailey, an anesthesiologist, spoke as president of the Gay and Lesbian Medical Association.
Another report, this one by the Institute of Medicine, concluded that L.G.B.T. patients are likely to have higher rates of chronic diseases, such as diabetes and high blood pressure.
The Institute of Medicine report also found that LGBT patients suffer from discrimination and fear, and that many encounter significant "difficulty gaining access to care" as the Times article noted. Consequently these patients also "face an increased risk of suicide, substance abuse and unaddressed domestic violence."
“These patients need to feel that they can tell their doctor they are gay and that their doctor will accept them,”
These are the words of Dr. Mitchell R. Lunn, senior author of the Institute of Medicine study.
The federal government has recently announced several initiatives to address disparities in L.G.B.T. health care access, but these two studies suggest that medical schools are not addressing gay and gender issues in ways that foste confidence or that address relevant medical issues.
The federal government has recently announced several initiatives to address disparities in L.G.B.T. health care access, but these two studies suggest that medical schools are not addressing gay and gender issues in ways that foste confidence or that address relevant medical issues.
The more cutting edge medical schools:
(1) integrate relevant material into courses
(2) offer electives
(3) inviting outside experts to speak on topics like gay parenthood, lesbians’ health or the use of hormones in transitioning from one gender to the other.
(4) foster discussions among medical students on sexual identity issues
(5) use actors, who play the part of LGBT patients, to help students address how their future LGBT patients deal with their own identity, which differs from that assigned to them by society at birth.
A serious related problem, according to the Times article is that "organizations responsible for accrediting medical schools and licensing physicians do not require that prospective doctors know about health care issues for lesbian, gay, bisexual or transgender patients."
Also, becuase of the relative newness of the field, and the limited research, medical schools often cannot find experts qualified to teach.
Giving LGBT patients full access to legal protections will help redress the embalance in health care delivery for LGBT citizens. This is yet one more reason why full civil marriage equality is important and must be protected in Maryland on General Election Day - November 6, 2012.
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