Doctors Call on Medical Schools to Teach LGBT Health

As a growing number of patients feel comfortable coming out to their doctors, the nation's medical schools and physicians' offices have become new arenas in the fight for LGBT equality.

Health care professionals are discovering that they often lack even basic knowledge about how to care for their LGBT patients. The problem is exacerbated by the fact that what ails gay men and lesbians can differ from what afflicts straight patients.

There are also vast differences among the people who are lumped together under the category of transgender. The health needs of transgender women are quite different from those transgender men will face throughout their lifetimes.

Yet few of the country's medical schools adequately prepare their students to properly care for their LGBT patients. And even at those schools that have begun to tackle LGBT health issues, the training hours devoted toward the topic are often hardly adequate.

Responding to this growing need, the Gay and Lesbian Medical Association assembled a task force of its members to create a comprehensive guide for health professional schools to teach their students, faculty and staff about LGBT health care.

The report, titled "Recommendations for LGBT Equity and Inclusion in Health Professions Education," is being released today (Thursday, October 11) to coincide with National Coming Out Day.

It covers everything from laying out just what are the LGBT community's key health concerns and steps schools can take to signify they are LGBT friendly to curriculum suggestions for teaching students how to treat LGBT patients.

"One of our primary goals as an organization is to design and create education programs and curriculum to ensure providers all across the country are equipped to handle the health issues of LGBT people," Hector Vargas, GLMA's executive director, told the Bay Area Reporter in a recent interview.

In addition to the report, which can be downloaded from the professional group's website at http://www.glma.org, GLMA created a four-part webinar series to teach about cultural competence in LGBT health. The first one in June attracted more than 400 registrants.

"We plan to do more," said Vargas. "We want to make sure allied providers, not just LGBT providers, are competent to address the very specific health issues that affect our community."

GLMA showcased the issue at its annual conference it held last month in San Francisco. The lead author of the new report, Shane Snowdon, presented a sneak peak of its findings and conclusions during one of the morning plenary sessions.

"This was a huge and sweeping project," noted Snowdon, who this summer joined the Human Rights Campaign as director of its health and aging program. "It is an eight ounce, 100-page document."

For 14 years Snowdon had served as the founding director of the UCSF Center for LGBT Health and Equity. She has long advocated for and provided LGBT health training at hundreds of hospitals, health professional schools, and other health organizations throughout the country.

With the creation of the GLMA report, Snowdon said any health care institution is now equipped to offer such training.

"This document puts forward recommendations that any health professional school can consider. It is not just for medical schools," she noted.

Better communication

One of the report's suggestions calls for doctors and other medical professionals to be trained in how to communicate with their LGBT patients so that they do not unknowingly use language that may be interpreted as negative or anti-gay.

"Every single health professional school has got to prepare their students for how to respond positively when their patient comes out," said Snowdon.

Other medical associations are also turning their attention to the needs of LGBT patients. At the American Association of Medical Assistants' conference last month, caring for LGBT people was highlighted during a morning session.

Despite using the problematic phrase "LGBT lifestyles," the AAMA confab's program said the panel would focus on why LGBT patients often have difficulty accessing adequate health care and would provide a tutorial on the proper terminology that applies to LGBT patients.

"We want all other health care associations to follow suit," said Snowdon, who later added that GLMA also wants medical schools to "get their hands rainbow dirty" and use the new report to create their own LGBT courses and trainings.

Great strides have already been made in recent years in getting some form of LGBT curriculum to be taught at medical schools.

"A vast number of medical schools are doing it," said Snowdon. "A few years ago I could have collected all the curriculum in the country in one document. Now that is no longer possible."

One breakout session during the GLMA conference featured speakers from various medical schools discussing the steps they and their faculty supporters took to add LGBT health issues to the curriculum.

A leader in the emerging field is the LGBT Medical Education Research Group at the Stanford University School of Medicine. Known as LGBT MERG, the group formed in 2007 and has its own extensive website at http://med.stanford.edu/lgbt/ where it shares data and information.

William White, a doctor of medicine candidate and an LGBT MERG investigator, presented results from a survey on if medical schools are teaching LGBT topics. It found that nearly all institutions teach about HIV and AIDS while only a handful address transgender care.

"In terms of students we surveyed, 71 percent wanted more clinical exposure to LGBT issues," said White.

Despite the latest pro-gay advances in the health care realm, Snowdon acknowledged there is more to be done to ensure LGBT patients receive proper care.

"It is not the last word. We are at the beginning of a whole new world in LGBT health learning," she said.

One focus of attention in the coming years will likely be the accreditation requirements for the nation's medical training schools. To date none are required to teach about LGBT health.

"As educators we are held to our accreditation bodies. In none of the agencies is there a single reference to gay, lesbian, bisexual or transgender," noted Dr. Abbas Hyderi, as associate dean of curriculum at the University of Illinois at Chicago College of Medicine.