Ep 6. LGBTQ+ topics in the medical curriculum


Introduction:

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Victoria Zhang (left) and Sarah Weicker (right) are two amazing classmates in my medical class, Class of 2019. Through research, advocacy and strategic planning, these two hard-workers were able to get a “gender dysphoria” lecture inserted permanently into our curriculum. They have eloquently pushed for more content and the faculty has listened: more changes are likely to come. Note to self: advocate.

Discussed:

  1. What is missing in medical curriculums and why it matters
  2. What Victoria and Sarah have found in their research
  3. How to provide safe care
  4.  Additional resources

Statistics Mentioned:

  1. Lesbian, gay, and bisexual, trans, queer, plus (LGBTQ+) individuals suffer mental and physical health disparities relative to heterosexual peers. Some diseases that are at increased risk include depression, anxiety, cancer, cardiovascular disease, asthma, diabetes, and other chronic conditions (Lick et al., 2013).
  2. The Trans PULSE Project is a survey that collected a wide range of information on 433 trans Ontarians. Some notable findings include about two-thirds of trans Ontarians reported that they had avoided some public spaces and situations because of a fear of harassment. This includes doctor’s offices. Among trans Ontarians overall, 46% reported that they had never experienced violence due to being trans, while 34% experienced verbal harassment or threats only, and 20% experienced physical or sexual violence (Bauer, Boyce, Coleman et al., 2010; Pyne, Bauer, Bradley et al., 2015))
  3. Of 150 medical schools in Canada and the US surveyed by Obedin et al. (2011), the median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours. 7% of schools reported 0 hours taught during preclinical years and 33% of schools reported 0 hours during clinical years (Obedin et al, 2011)
  4. American Psychiatric Association definitions to gender, gender expression, gender identity and more. https://www.apa.org/pi/lgbt/resources/sexuality-definitions.pdf

Summary:

I admire Victoria and Sarah for turning their passion into real changes in the training of future doctors. As physicians, we can have a leading role in shaping safe healthcare environments. Ignorance can create awkward patient interactions with lasting negative effects. My favorite quote from the interview “onus is on us as the healthcare workers to get educated about LGBTQ+ issues.” I definitely plan to attend more lectures and workshops.

Resources Used:

Bauer G, Boyce M, Coleman T, et al. Who are trans people in Ontario? Trans PULSE Project E-Bulletin 2010; 1(1). Available in English and French at http://transpulseproject.ca/research/who-are-trans-people-in-ontario/

Lick, D. J., Durso, L. E., & Johnson, K. L. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science8(5), 521-548.

Obedin-Maliver, J., Goldsmith, E. S., Stewart, L., White, W., Tran, E., Brenman, S., … & Lunn, M. R. (2011). Lesbian, gay, bisexual, and transgender–related content in undergraduate medical education. Jama,306(9), 971-977.

Pyne J, Bauer GR, Bradley K. Transphobia and other stressors impacting trans parents in Ontario, Canada. Journal of GLBT Family Studies 2015;11(2):107-126. Available at http://www.tandfonline.com/doi/abs/10.1080/1550428X.2014.941127

Further Supports (recommended by Victoria and Sarah)

  • Medical

1. Endocrine Therapy for Transgender Adults in British Columbia: Suggested Guidelines: http://transhealth.phsa.ca/wp-content/uploads/sites/15/2016/01/BC_Trans_Adult_Endocrine_Guidelines_2015-Ver1.2-updated-Jan-11-2016.pdf
2. The WPATH Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People, Version 7 https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf

3. Transgender Health Information Program (THiP) http://transhealth.phsa.ca

  • Community

1. Qmunity http://qmunity.ca/
2. Catherine White Holman Wellness Centre http://www.cwhwc.com/
3. Prism Services (VCH) http://www.vch.ca/locations-and-services/find-health-services/?program_id=265

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Thanks Juan for taking the time to talk to us about the importance of LGBTQ+ health!

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