Abstract
Purpose: Lack of physician training contributes to health care disparities for transgender people. The limited generalizability and feasibility of published training approaches lessen their utility in lowering barriers for other institutions to adopt similar training.Methods: All first-year medical students at the Mayo Clinic Alix School of Medicine (MCASOM) in Minnesota and Arizona received a 1-h lecture introducing key concepts related to transgender people and their health disparities. Students completed a 21-question survey before and after the lecture, and 1 year later. Chi-square likelihood coefficients were used to compare responses between the three time points.Results: Eighty-six of 100 students answered the prelecture survey (86% response rate); 70 the postlecture survey; and 44 the 1-year follow-up survey. Twenty-five (29%) students had prior education in any lesbian, gay, bisexual, and transgender (LGBT+) health disparities, but this did not correlate with more favorable attitudes or knowledge. LGBT+ students and those with close LGBT+ friends had the most favorable attitudes and knowledge. The proportion of students comfortable with caring for transgender people changed significantly (76% self-reported very comfortable prelecture vs. 91% postlecture, p=0.0073) and remained at 89% 1 year later. The proportion of students comfortable with a transgender patient scenario significantly increased (67% self-reported very comfortable prelecture vs. 87% postlecture, p=0.032) even when surveyed 1 year later (95% very comfortable, p<0.0001).Conclusion: This study demonstrates that a 1-h lecture can increase the proportion of medical students who demonstrate positive attitudes and correct knowledge on transgender patient care for at least a year, and how a survey can gather essential information on student learning needs to guide training development.
Highlights
People who belong to gender and sexual orientation minority groups suffer worse health outcomes than the general population[1,2,3] due to barriers in accessing medical care[4] as well as discrimination[5] that can lead to care refusal, inferior treatment, or even verbal abuse from health care workers.[6,7,8,9] In addition to discrimination, lack of knowledge about special health care needs may exacerbate the quality deficit experienced by gender and sexual orientation minority groups
The lecture included an explanation of the spectrum of identities associated with gender expression and sexual orientation, a broad overview of LGBT + health disparities, and the description of a patient scenario to demonstrate how subtle aggressions by medical staff may lead to less health care utilization and poorer treatment outcomes (Appendix Tables A1 and A2)
Survey methodology A 21-question voluntary, anonymous online survey focusing on transgender health was e-mailed to all 100 students pre- and postlecture using Mayo Cliniclicensed Research Electronic Data Capture (REDCap) survey platform (Appendix Table A3)
Summary
People who belong to gender and sexual orientation minority groups suffer worse health outcomes than the general population[1,2,3] due to barriers in accessing medical care[4] as well as discrimination[5] that can lead to care refusal, inferior treatment, or even verbal abuse from health care workers.[6,7,8,9] In addition to discrimination, lack of knowledge about special health care needs may exacerbate the quality deficit experienced by gender and sexual orientation minority groups.
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