LGBT Medical Education: First-Year Medical Students’ Self-Assessed Knowledge and Comfort with Transgender and LGB Populations

Abstract

Medical education lags with respect to care for lesbian, gay, bisexual, and transgender populations, all of which experience disparities around access to care and health outcomes. (1) To evaluate M1 students’ perceived preparedness to care for transgender patients compared to LGB populations, (2) to identify knowledge and skills gaps, and (3) to recommend curricular developments. An online survey was administered to M1 students (N = 137) and assessed knowledge of and comfort levels with special populations. Responses were compared regarding transgender and nonbinary populations to those regarding LGB ones. Analyses consisted of t tests of response means and natural language processing of a free-text field querying for knowledge and skills needed to work with these subpopulations. With a 100% response rate, students expressed significantly lower levels of knowledge and comfort regarding transgender and nonbinary populations compared to LGB ones. Natural language processing of the sentiment of the free-text field revealed greater magnitude for transgender populations (83.7 vs. 62.1) and equal average sentiment scores (0.2). Content also revealed a greater emphasis on direct interaction with trans and nonbinary persons in order to develop gender-affirming language and skills whereas LGB content focused on acquiring knowledge of LGB health issues. M1 students feel less knowledgeable about and comfort with transgender persons compared to LGB ones; they want more exposure to and interaction with trans-patient experiences in order to develop gender-affirming language and clinical practices that address the range of healthcare needs.