An Analysis of the Presence and Composition of OutLists at United States, Canadian, and European Medical Institutions

Lesbian, gay, bisexual, and/or transgender (LGBT) cultural competency across the intersectionalities of gender identity, sexual orientation, and race among healthcare professionals

Background

There is some data regarding lesbian, gay, bisexual, and transgender (LGBT) cultural competency among healthcare professionals. While few studies have indicated differences in competency between heterosexual and sexual minority professionals, no known studies have assessed LGBT cultural competency among diverse groups with multiple minority identities. This study aimed to characterize healthcare professionals’ LGBT cultural competency by comparing twelve different demographically diverse healthcare professional groups based on gender identity, sexual orientation, and race.

Methods

Deidentified data (N = 2254) was aggregated from three independent studies (i.e., healthcare professional students, psychiatry residents, and dementia care providers). A series of multivariate analyses of covariance were conducted with groups (based on gender identity, sexual orientation, and race), other demographic variables as independent variables, and LGBT-Development of Clinical Skills Scale scores (Overall LGBT-DOCSS, Clinical Preparedness, Attitudinal Awareness, and Basic Knowledge) as dependent variables.

Findings

Compared to men, women reported significantly higher LGBT-DOCSS scores, except significantly lower Clinical Preparedness. Compared to cisgender, heterosexual professionals, cisgender, sexual minority professionals and gender minority professionals reported significantly higher LGBT-DOCSS scores. There were several other differences among groups, such as heterosexual, cisgender, White/Caucasian men reporting low LGBT-DOCSS scores but high Clinical Preparedness; heterosexual, cisgender, White/Caucasian women with high LGBT-DOCSS scores except Clinical Preparedness; heterosexual, racial minority professionals with low LGBT-DOCSS scores; and gender, sexual, and racial minority professionals with the highest LGBT-DOCSS scores.

Conclusions

There are subtle, yet important, differences in LGBT cultural competency among healthcare professionals. More diversity, intersectionality, and multiple minority identities appear to lead to higher competency. Appreciating these gender, sexual, and racial minority professionals’ unique perspectives may promote the development of better, more culturally affirming LGBT health education.

Facilitating Identity Compatibility in Mentorships: Implications for Diversity in Medicine

Despite intentional efforts to improve diversity in medicine, there is pronounced underrepresentation of minority groups and non-disclosure of minority identities by medical students due to societal stigmas and fears of acceptance. One way that medical schools address this challenge in supporting diverse student backgrounds is by facilitating faculty mentorship programs with underrepresented minority (URM) students. These efforts are valuable, but they are unfortunately not available at all institutions and do not always allow URM students to engage in the process of choosing a mentor confidentially. Medical schools largely do not make self-reported information from faculty about their various identities and allyships available to medical students, which limits the resources that students have to independently forge these connections. Helping students form their own mentor-mentee relationships by making faculty demographics available can lead students to find individualized support across their medical training. Identity compatibility between students and their role models has shown to correlate with academic achievement and senses of belonging. Enforcing that all medical schools share the identities of faculty who choose to disclose this information with students will thus be helpful to further diversity as a continuous commitment in medical education.