LGBTQ Healthcare Research Articles

Lesbian, gay, bisexual, transgender, and queer health-related educational experiences in undergraduate medical curricula among Thai medical schools (LEAD-IN)

Purpose In Thailand, Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals face significant health disparities and discrimination in healthcare. A primary cause is the lack of knowledge among doctors and their negative attitudes towards LGBTQ people. The purpose of this study was to explore the current undergraduate medical curricula of medical schools in Thailand concerning learning outcomes, contents, teaching and learning methods, and assessment methods in the field of LGBTQ health. It also sought to gather opinions from principal stakeholders in curriculum development. Methods The authors employed a mixed-methods approach with a convergent design to conduct the research. Quantitative data were collected from 23 deputy deans of educational affairs using a standardized interview form, and qualitative data were obtained through in-depth interviews with key stakeholders including 16 LGBTQ healthcare receivers, 22 medical students, and three medical teachers. Both datasets were analyzed simultaneously to ensure consistency. Results The findings indicate that none of the medical schools had established learning objectives related to LGBTQ healthcare within their curricula. Of the institutions surveyed, 8 out of 15 (53.3%) offered some form of teaching on this topic, aligning with the qualitative data which showed 7 out of 17 institutions (41.2%) provided such education. The most frequently covered topics were gender identity and sexual orientation. Lectures were the predominant teaching method, while multiple-choice questions were the most common assessment format. There was a unanimous agreement among all principal stakeholders on the necessity of integrating LGBTQ healthcare into the M.D. program and the professional standards governed by the Thai Medical Council. Conclusions Although some Thai medical schools have begun to incorporate LGBTQ health into their curricula, the approach does not fully address the actual health issues faced by LGBTQ individuals. Future teaching should emphasize fostering positive attitudes towards LGBTQ people and enhancing communication skills, rather than focusing solely on the cognitive aspects of terminology. Importantly, medical educators should serve as role models in providing competent and compassionate care for LGBTQ patients.

11.P. Workshop: Inequities in physical and mental health, and health care utilization for LGBTQ groups across Europe

Abstract Compared to heterosexual cisgender-identified individuals, lesbian, gay, bisexual, and transgender and queer (LGBTQ) individuals evidence pronounced poor mental and physical health outcomes, as well as sub-optimal healthcare access and utilization. Yet, most of the evidence documenting these disparities comes from a small group of Western countries. This limited knowledge across health conditions and geographical regions leaves multiple important questions unanswered. In particular, it remains unknown to what degree these disparities may be generalizable to contexts that have not yet been studied. This workshop includes novel reports on disparities in health, wellbeing, and healthcare access between LGBTQ groups and their heterosexual cisgender counterparts across several European countries where such data were not previously available. Through these four presentations, we explore health inequalities across Europe in physical and mental health, as well as healthcare utilization. Findings emphasize a continued need for attention to systems that can be modified (e.g., trainings of healthcare cadre, resource allocation) to reduce health disparities that uniquely burden LGBTQ groups. Andreas Pfister (Zurich University of Applied Sciences, Switzerland) will present the first national systematically documented psychosocial burden and healthcare access disparities for LGBTQ individuals compared to their heterosexual cisgender counterparts in Switzerland. Sladjana Baros (Centre for Disease Prevention and Control, Department for HIV, Hepatitis, Sexually Transmitted Infections and Tuberculosis, Institute of Public Health of Serbia ‘Dr Milan Jovanovic Batut’, Republic of Serbia) will present findings from the HIV testing cascade among men who have sex with men at high risk for HIV. Michal Pitonak (Center for Epidemiological and Clinical Research of Drug Abuse and Dependence, National Institute of Mental Health, Klecany, Czech Republic) will present data on disproportionate rates of psychological distress reported by lesbian, gay and bisexual individuals compared to heterosexual individuals in the Czech Republic. Lastly, Luis Roxo (Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden) will present population-based data on differences in mental health services and unmet mental health needs based on sexual orientation among Swedish young adults. Key messages • Despite being the first of such evidence, findings from these four European countries are consistent with reports from other global regions, signalling that these disparities are universal. • A clear need emerges for structural changes to increase access to and expertise in affirmative LGBTQ healthcare to reduce disproportionate morbidity rates for LGBTQ people in Europe.

The Experiences ofLGBTQ Healthcare Professionals within Military Medical Culture.

Creating a positive workplace culture affects patient outcomes and force readiness. An inclusive workplace culture is especially important for lesbian, gay, bisexual, transgender, and queer (LGBTQ) military healthcare professionals, who have historically faced discrimination within the United States military. While research has examined LGBTQ service members' experiences in the military as a whole, there is a gap in the professional literature regarding LGBTQ healthcare workers' experiences within military medicine. This qualitative phenomenological study explored the experiences of ten LGBTQ military healthcare professionals. We interviewed each participant for one hour. Our research team then coded each interview and came to a consensus on how to organize these codes into emerging themes. We used reflexivity and member checking to increase the credibility of our results. Four themes emerged from our data analysis: (1) implicit bias; (2) explicit bias; (3) response to discrimination; and (4) recommendations for improving workplace culture. The participants described both the underlying and outright discrimination they faced at work. They made recommendations for reducing this discrimination through education, training, and increased leadership representation. Our results revealed that LGBTQ healthcare professionals continue to face discrimination in the workplace. This discrimination must be addressed to create an inclusive workplace environment within military medicine, which will enhance force readiness.

Do Hospitals Achieving "Leader in LGBTQ Healthcare Equality" Maintain Higher Patient Scores Compared To Nonleaders?

The lesbian, gay, bisexual, transgender, and queer (LGBTQ) population deals with complex medical and behavioral issues coupled with barriers in accessing both healthcare and health insurance leading to poorer health outcomes as compared with the general population. Because this community is often overlooked in efforts to improve minority health disparities, in 2007, the Human Rights Campaign Foundation introduced the Healthcare Equality Index (HEI) for evaluating healthcare facilities' policies and practices related to the equity and inclusion of their LGBTQ patients, visitors, and employees. This study's aim was to determine whether the LGBTQ Healthcare Equality Leader institution designation advantage found by DiLeo et al (2020) has a continuing positive effect on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) performance. We found that patient scores for both Overall Rating and Willingness to Recommend were higher with noted improvement for HEI Leader institutions as compared with non-HEI Leader institutions over this study's 3-year period. Based on the findings of this study, it can be implied that hospitals do receive a return on their investment for achieving or maintaining the HEI Leader designation and this investment benefits all populations served by the organization inferred by their maintained higher patient experience scores.

Bridging the gap: online availability of gynecological care for lesbian, gay, bisexual, transgender, and questioning communities

To analyze online visibility of LGBTQ, specifically, transgender gynecologic health services on obstetrics and gynecology clinic websites and correlate visibility with geographic location. The term “Obstetrics and Gynecology Clinic [state name of interest]” was used to locate gynecologic clinics’ websites on Google Maps (GM) between May 2021 and August 2021. The first 40 GM results of the states’ North and South regions were analyzed. Data points collected included zip code, practice size, hysterectomy offered, mention of LGBTQ services, and academic affiliation. Clinics without websites were excluded. Clinic zip code was used to extract data on income, ethnic distribution, and population size from the US Census Public Data. Chi-square test of independence cross examined association between each variable and LGBTQ visibility on clinic websites. 818 Ob/Gyn clinics were found through GM search. 82 providers (10%) explicitly advertised LGBTQ care provided on their website. Cities were classified by population >250,000(n=159) and population <250,000(n=659), 20.1% vs 7.6% mentioned ability to provide LGBTQ inclusive care (p < 0.001). Clinics affiliated with an academic institution were 3 times more likely to advertise LGBTQ services than clinics not affiliated with an academic institution (9% vs 31.6%, p < 0.001). Analysis of ethnic distribution found clinics in cities with majority Caucasian vs non-Caucasian population showed no significant difference in transgender care visibility (9.3% vs 12.4%, p =0.202). Comparing median household income as greater than or less than national average, no difference was noted in advertised services for LGBTQ populations (9.8% vs 10.1%, p= 0.874). Larger clinics, defined as having 6 or more providers, were twice as likely to list LGBTQ services available than smaller clinics, 5 or less providers, (15.1% vs 6.3%, p<0.001). Clinics that specifically mention hysterectomy services were not more likely to mention LGBTQ services than those that don’t mention hysterectomy services (8.1% vs 11.6%, p=0.104). Of the five geographical regions of the US, the Southeast had a significantly lower incidence of clinics that advertised LGBTQ services when compared to the West and Northeast (p < 0.001). Online visibility of LGBTQ health services in OB/GYN are low, with less than 10% of clinics advertising LGBTQ services. Clinics in cities with a large population, associated with an academic institute, or considered a large clinic are more likely to advertise for such services. These findings demonstrate disparity in access to LGBTQ healthcare, specifically transgendered patients seeking gynecological services. Further efforts should be made to increase inclusivity in promoting LGBTQ services on Obstetrics and Gynecology clinics' websites as many patients use the internet as a tool to locate a suitable physician.

An etic view of LGBTQ healthcare: Barriers to access according to healthcare providers and researchers

Current research in SGM health outcomes and disparities has made great strides, but a more in-depth understanding of the health needs of the population and how to address them is still required. This study aims to identify the health needs of the SGM population through in-depth interviews with researchers and health care providers that have spent their careers working with members of this population. Four themes were identified: LGBQ and trans outside of Heteronormativity, the multifaceted aspects of health, impact of discrimination, and healthcare system barriers. Finally, we explore potential multi-level solutions to this dilemma from a Social Ecological perspective.

Past, Present, and Future of LGBTQ Health Care

Past, Present, and Future of LGBTQ Health Care

Interactive Session for Residents and Medical Students on Dermatologic Care for Lesbian, Gay, Bisexual, Transgender, and Queer Patients.

IntroductionDespite increasing emphasis on LGBTQ health in medical education, evidence-based training on LGBTQ patient care in dermatology is lacking. We designed an interactive online didactic session on dermatologic care of LGBTQ patients for medical students and dermatology residents.MethodsSession content was based on continuing medical education articles and incorporated preexisting LGBTQ-inclusive policies, environments, and videos. We implemented the session via a web-based videoconferencing platform as part of a preexisting resident lecture series. We began with a 90-minute lecture on LGBTQ health care disparities and dermatologists’ roles, best practices for providing inclusive care, and dermatologic health concerns and screening recommendations in LGBTQ populations. To solidify knowledge and promote practice of learned skills, a 30-minute interactive role-playing session followed where participants acted as observer, patient, or provider in three distinct clinical scenarios pertaining to dermatologic care of LGBTQ patients. Participants completed baseline and follow-up surveys, which included a psychometrically validated clinical skills scale and an ad hoc knowledge assessment.ResultsBaseline and follow-up scores from the clinical skills scale increased overall (0.7; 95% CI, 0.5–0.9; p < .001), in self-reported clinical preparedness (1.1; 95% CI, 0.5–1.6; p = .001), and in basic knowledge (0.8; 95% CI, 0.3–1.4; p = .003).DiscussionAn online interactive didactive session on dermatological care of LGBTQ patients increased participants’ clinical preparedness and basic knowledge. Implementation of similar sessions at other institutions can improve gaps in preparing residents and medical students in dermatological care of LGBTQ patients.

Obstetrics and Gynecology Resident Physician Experiences with Lesbian, Gay, Bisexual, Transgender and Queer Healthcare Training.

To assess obstetrician-gynecologist (Ob/Gyn) resident experiences with and preferences for lesbian, gay, bisexual, transgender, and queer (LGBTQ) healthcare training. A cross-sectional, web-based survey was deployed to residents from accredited Illinois Ob/Gyn training programs. The survey included 32 questions on resident demographics, LGBTQ training, and self-perceived preparedness in providing LGBTQ patient care. Of 257 eligible Ob/Gyn residents, 105 (41%) responded. Fifty percent of residents felt unprepared to care for lesbian or bisexual patients and 76% felt unprepared to care for transgender patients. Feeling prepared to provide care for lesbian or bisexual patients was associated with attending a university-based program, working in a hospital without religious affiliation, and year of training. Feeling prepared to provide healthcare for transgender patients correlated with grand rounds focused on LGBTQ health and supervised clinical involvement. Regarding training, 62% and 63% of participants stated their programs dedicate 1-5h per year to lesbian/bisexual healthcare and transgender healthcare training, respectively. Concurrently, 92% desired more education on how to provide healthcare to LGBTQ patients. Perceived barriers to receiving training in LGBTQ healthcare included curricular crowding (85%) and lack of experienced faculty (91%). Our assessment indicates Illinois Ob/Gyn residents feel inadequately prepared to address healthcare needs of LGBTQ patients. Although barriers exist, residents desire more education and training in providing healthcare to the LGBTQ community. Future work is needed to address this gap through curricular development to ensure that Ob/Gyn residency graduates are prepared care for LGBTQ patients.

Designing an interprofessional Facebook discussion group to teach about LGBTQ healthcare disparities and inclusive practices

Objective: Training on lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) healthcare and inclusive practice is lacking in curricula across health professions, contributing to health disparities. The purpose of this study was to evaluate an interprofessional learning activity on LGBTQ healthcare disparities and inclusive practices delivered in a closed Facebook group. Design: Asynchronous, online platforms, like social media, offer a simple means of connection and discussion for interprofessional education. Setting: An academic health centre in the Southern USA. Methods: The learning activity consisted of (1) pre- and post-quizzes assessing knowledge about LGBTQ healthcare, (2) content review of required readings and a video and (3) daily discussion threads. Students completed individual reflection essays about interprofessional education and practice and the Quadruple Aim. Results: Two cohorts of interprofessional students completed the activity. Average quiz scores increased post-activity. Both the Facebook discussion threads and reflection essays demonstrated that students recognised the need to incorporate LGBTQ-inclusive practices into their future professional practice, as well as recognised the valuable insight of their interprofessional team members. Students had mixed perspectives about Facebook as a discussion platform for interprofessional education. Conclusion: Facebook groups provide a feasible platform to implement interprofessional education on LGBTQ-inclusive healthcare practice and stimulate student discussion.

"Fat broken arm syndrome": Negotiating risk, stigma, and weight bias in LGBTQ healthcare.

In the U.S., the weight of LGBTQ people-and sexual minority women in particular-is a key focus for those addressing sexual and gender minority health disparities. Sociomedical stigma related to both fat and sexuality, however, complicates patient-provider perceptions and discussions about weight and health. I analyzed data from interviews with LGBTQ patients, healthcare employees, and observations at a LGBTQ healthcare organization to reveal how weight bias becomes a barrier to care for LBQ cisgender women, transgender men, and nonbinary people assigned female. Understood by patients as similar to "trans broken arm syndrome,"-wherein providers attribute health concerns of trans people to minority gender identities and gender affirming care-patients report "fat broken arm syndrome," wherein providers are perceived to attribute patient health concerns to weight. Patients interpret weight bias as intersectional stigma-related to multiple marginalized identities and embodiments-that puts their health at risk. Healthcare professionals make sense of risk, however, through competing fat frames. Although patient narratives suggest the promise of utilizing stigma-reduction approaches, many providers-typically those who do not share patient standpoints-emphasize the importance of framing fat as an urgent health risk in order to "do no harm." This case advances knowledge by demonstrating the relational process through which interventions designed to ameliorate health disparities may inadvertently discourage marginalized, "at-risk" patients from healthcare access and adherence.

Rainbows and "Ready for Residency": Integrating LGBTQ Health Into Medical Education.

IntroductionTo provide appropriate and sensitive care for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, providers must learn specific skills and guidelines. Most medical schools lack formal education on LGBTQ health, particularly for adolescent patients.MethodsWe developed an Introduction to LGBTQ Health course for fourth-year medical students as part of a monthlong Ready for Residency curriculum in March and April of their graduating year. The course addressed guidelines recommended in the care of LGBTQ individuals utilizing problem-based learning methodology. Through learner-led discussion, students worked in small groups to research case-based scenarios and reported their findings to the larger group, followed by teaching points from a facilitator. The course was evaluated on curricular perception using a 5-point Likert scale and open-ended feedback.ResultsOne hundred forty-six students participated in the curriculum; 103 completed the session evaluation. Mean total scores were 4.6 out of 5 in March and 4.7 out of 5 in April after changes were made based on student feedback, namely, increasing the session from 50 to 80 minutes and decreasing session size from 72 students to 36. Students felt the session was well planned and run, engaging, and relevant; appropriately integrated evidence-based medicine; and taught them what they hoped to learn.DiscussionMany medical schools lack curricula dedicated to LGBTQ health care. Implementing this mandatory LGBTQ health course was well received and highly rated by almost all students regardless of anticipated specialty. The session could be easily replicated at medical schools across the country.

Answering the Call: Educating Future Nurses on LGBTQ HealthCare

ABSTRACT The purpose of this population-focused educational strategy was to improve knowledge and attitudes of senior-level baccalaureate nursing students regarding LGBTQ health. Surveys were conducted to assess achievement in learning objectives: (a) understanding the prevalence and impact of health disparities among individuals who identify as LGBTQ, (b) understanding the ways to provide effective support for individuals who identify as LGBTQ, (c) identification of ways to engage with individuals who identify as LGBTQ in an active partnership for health promotion. The majority of students responded to survey questions acknowledging that communication skills and style changed as a result of the innovation, new or advanced knowledge was obtained and a better awareness upon which to base decisions/actions in the practice setting was gained. All health-care professionals are encouraged to practice open-mindedness and should welcome opportunities to be educated on best practice related to care of LGBTQ individuals.

Erratum: Perioperative Provider and Staff Competency in Providing Culturally Competent LGBTQ Healthcare in Pediatric Setting [Corrigendum

[This corrects the article DOI: 10.2147/AMEP.S220578.].

Understanding the Unique Needs for Members of LGBTQ Community in the Hematopoietic Stem Cell Transplant (HSCT) Setting: Improving Staff Accountability and Comfort through Education

Topic Significance & Study Purpose/Background/Rationale The LGBTQ community faces significant barriers to healthcare in the United States. Battling a cancer diagnosis and committing to a HSCT is daunting to all; fighting as a LGBTQ individual can be even more overwhelming. LGBTQ patients may experience stigma and discrimination in the health care system. Many approach their treatment expecting continued misunderstanding from healthcare professionals. Methods, Intervention, & Analysis The aim of this project was to educate the HSCT multi-disciplinary staff about healthcare disparities experienced by the LGBTQ community and to engender sensitivity among staff. Tools for effective communication were provided in order to deliver exceptional care to all patients. With appropriate permissions, a PowerPoint from the online National LGBTQ Health Education Center was presented at multiple teaching sessions for day and night shift staff. Further independent training through the National LGBTQ Health Education Center was encouraged and multiple open discussions were held with staff over a 6-month period. An anonymous Qualtrics survey was distributed at the end of the 6-month period to evaluate the effectiveness of the education. Findings & Interpretation Fifty-three staff members participated in training and 28 surveys were returned. Only twenty-one percent of respondents considered themselves knowledgeable about LGBTQ healthcare needs prior to this education. After completing the course, eighty-nine percent of respondents rated themselves as knowledgeable and all indicated that they are likely to utilize these communication skills to provide care to future LGBTQ patients. Discussion & Implications Providing appropriate education to healthcare professionals can increase awareness of LGBTQ needs and improve accountability for meeting those needs. Education and open dialogue are important steps toward embracing the LGBTQ community and delivering safe, compassionate care to increasingly diverse patient populations.

A Novel Curriculum for Medical Student Training in LGBTQ Healthcare: A Regional Pathway Experience.

Background:Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face considerable health disparities, often due to a lack of LGBTQ-competent care. Such disparities and lack of access to informed care are even more staggering in rural settings. As the state medical school for the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine (UWSOM) is in a unique position to train future physicians to provide healthcare that meets the needs of LGBTQ patients both regionally and nationally.Objective:To describe our methodology of developing a student-driven longitudinal, region-wide curriculum to train medical students to provide high-quality care to LGBTQ patients.Methods:A 4-year LGBTQ Health Pathway was developed and implemented as a student-led initiative at the UWSOM. First- and second-year medical students at sites across the WWAMI region are eligible to apply. Accepted Pathway students complete a diverse set of pre-clinical and clinical components: online modules, didactic courses, longitudinal community service/advocacy work, a scholarly project, and a novel clinical clerkship in LGBTQ health developed specifically for this Pathway experience. Students who complete all requirements receive a certification of Pathway completion. This is incorporated into the Medical Student Performance Evaluation as part of residency applications.Results:The LGBTQ Health Pathway is currently in its fourth year. A total of 43 total students have enrolled, of whom 37.3% are based in the WWAMI region outside of Seattle. Pathway students have completed a variety of scholarly projects on LGBTQ topics, and over 1000 hours of community service/advocacy. The first cohort of 8 students graduated with a certificate of Pathway completion in spring 2020.Conclusions:The LGBTQ Health Pathway at UWSOM is a novel education program for motivated medical students across the 5-state WWAMI region. The diverse milestones, longitudinal nature of the program, focus on rural communities, and opportunities for student leadership are all strengths and unique aspects of this program. The Pathway curriculum and methodology described here serve as a model for student involvement and leadership in medical education. This program enables medical students to enhance their training in the care of LGBTQ patients and provides a unique educational opportunity for future physicians who strive to better serve LGBTQ populations.

Student Journal Club to Improve Cultural Humility with LGBTQ Patients.

Health degree programs provide opportunities to reduce disparities in care for LGBTQ patients by exposing students to LGBTQ communities and current health issues. However, LGBTQ content is mostly absent from medical school curricula. This mixed method assessment study, conducted during the 2018 to 2019 academic year, examined the feasibility of implementing a medical student journal club focused specifically on LGBTQ health issues as a complementary training tool to support efforts to create an inclusive educational environment. Compared to the pre-test, mean response scores increased for most of the parameters including familiarity with LGBTQ healthcare issues, confidence in the ability to identify harmful medical provider practices, and reading and assessing scientific literature. Qualitative data showed increased confidence, comfort and knowledge about LGBTQ health barriers. This study offers a framework for using a journal club to provide an effective platform for enhancing students’ LGBTQ cultural humility and research literacy.

&lt;p&gt;Perioperative Provider and Staff Competency in Providing Culturally Competent LGBTQ Healthcare in Pediatric Setting&lt;/p&gt;

IntroductionChildren and adolescents identifying as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) may feel reluctant to seek medical care due to stigma and the possibility of negative interactions with health care providers. Due to the short duration of the perioperative period, the interaction in this setting is limited and providers may not have the time to develop a rapport with the patient. It is imperative that staff are trained to address the patient and family in a culturally competent manner.MethodsWe undertook surveys before and after a 2 part educational series among the pediatric perioperative staff to understand the impact of providing education and cultural competency training regarding caring for patients who identify as LGBTQ. Providers self-reported their knowledge and comfort on a 1–5 point scale (5 being most knowledgeable or comfortable) in 6 domains of caring for LGBTQ patients. Objective knowledge of LGBTQ issues was assessed using 7 questions based on lecture material. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.ResultsThe analysis included 90 responses. Before training, median ratings of knowledge and comfort were 3 or 4 out of a maximum of 5 for each domain. The pre-training median score on the 7-item test of LGBTQ cultural competency was 5 (IQR: 4, 6). After training, knowledge and comfort self-ratings did not improve, but the score on the objective knowledge test increased to a median of 6 (IQR: 4, 7; p=0.011) of 7 possible points.DiscussionAnesthesia providers participating in LGBTQ cultural competency training self-reported high levels of knowledge and comfort with providing care to LGBTQ patients even before formal training was provided. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.

Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review

BackgroundLesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients.MethodsThe authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale.ResultsThe search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers.ConclusionsStrategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

A cancer screening crisis for transgender patients: Discrimination, patient unease, provider ignorance, and a highly gendered health care system are impeding cancer screening and risk assessment in the transgender population. In this article, the first of a 2-part series, we explore how clinicians can begin to address those barriers.

A cancer screening crisis for transgender patients: Discrimination, patient unease, provider ignorance, and a highly gendered health care system are impeding cancer screening and risk assessment in the transgender population. In this article, the first of a 2-part series, we explore how clinicians can begin to address those barriers.