Background: Lesbian, gay, bisexual and transgender (LGBT) individuals are a minority population with unique healthcare needs and challenges. Lack of focused education of medical providers in the healthcare needs of this vulnerable population creates a significant barrier to care and exacerbates health disparities faced by this population.
Objective: To identify factors affecting self-perceived preparedness and comfort of medical trainees to address healthcare needs of LGB and transgender individuals at a large urban tertiary-care teaching hospital.
Methods: An anonymous survey was emailed to 365 residents and fellows across all specialties at Albert Einstein Medical Center, Philadelphia PA. The main outcome was self-perceived preparedness and comfort addressing healthcare needs of LGB and transgender individuals. Responses were collected on a 5-point Likert scale from 0 to 4 (Strongly Disagree = 0 to Strongly Agree = 4). Multivariable linear regression models included age, race, gender, identification with LGBT community, country of medical education, year of current postgraduate training and specialty.
Results: 165 (45%) trainees completed the survey. 22% of respondents were in Internal Medicine, 21% in Emergency Medicine,15% in Pediatrics and 9% in Psychiatry. 11.5% considered themselves members of the LGBT community and 40% viewed themselves as allies. Approximately half of the respondents had received prior training in the healthcare needs of LGB (54%) and transgender individuals (47%). The mean scores were 2.9 for level of preparedness and comfort for LGB and 2.7 for transgender individuals, and 3.1 for knowledge and comfort addressing sexual orientation and gender identity with patients. Mean scores were higher for addressing LGB health needs across almost all categories (Table 1). On multivariable analysis, self-perceived preparedness and comfort in addressing LGBT healthcare needs was significantly higher among those who had received prior training in LGBT healthcare needs, self-identified as a member or ally of the LGBT community (Table 2). Male gender was associated with higher mean scores for LGB health (Table 2). Specialty, country of medical education, and year of training were not significantly associated.
Conclusion: The majority of medical trainees felt prepared and comfortable addressing the healthcare needs of LGB and transgender individuals. Trainees felt more prepared and comfortable in addressing LBG healthcare needs than those of transgender patients. Self-identification or alliance with the LGBT community and prior training in LGBT health care needs were significantly associated with higher scores. Specific curricula addressing the specific health care needs of this vulnerable population could benefit both trainees and their LGBT patients.
