Blog two of our Pride series covers education. What are the needs of healthcare providers in caring for LGBTQ2+ patients?

Every healthcare provider was, at one point, a student. So when it comes to providing quality care for all patients – including LGBTQ2+ individuals with cancer – it all starts with education! This blog is going to focus on what the research tells us about the education that healthcare professionals and trainees are lacking when it comes to caring for trans patients and clients.

An interview study with 13 physicians based in Ontario, Canada asked participants about the barriers they perceive in providing care to their trans patients and clients (Snelgrove et al., 2012). There was a common, over-arching theme in participant responses: physicians didn’t know what resources were available to help them to care for their trans patients and clients. As one participant, a family/HIV primary care physician, stated: “…despite trying to find ways to improve my expertise, I just didn’t know where to go or who to talk to, or where to get the information” (p. 4). Easy access to reputable resources, particularly resources that are specific to physicians, was a need highlighted by participants in their interviews. Doctors felt that they lacked the knowledge needed to care for trans patients and clients, and noted that they did not receive sufficient training related to trans healthcare while in medical school. Participants admitted to having to rely on their patients to educate them around their needs, while acknowledging that it isn’t ideal; to quote the same physician from earlier: “…I really appreciated that the community themselves have mustered up that internal support and guide physicians, but that’s pretty suboptimal when patients have to tell doctors…how to do what we should know how to do” (p. 6).

Regarding research on medical students, an online study at a UK university investigated students’ experiences with, knowledge about, and attitudes regarding LGBTQ+ individuals and their healthcare (Parameshwaran et al., 2017). Unfortunately, a large majority of participants (85%) indicated that they had not received training specific to the healthcare needs of LGBTQ people, and 68% indicated that they did not feel confident in knowing where they could access resources on providing care to this population. Perhaps especially relevant to working with trans patients and clients, only 4% of participants indicated either “always” or “often” asking patients for their pronouns, and 36-44% indicated either “never” or “rarely” asking patients about their gender identity in a variety of healthcare settings (mental, reproductive, and sexual). Further, participants reported a lack of confidence in their understanding of terms specific to gender-affirming care (e.g., “phalloplasty”, “neovagina”).

Something important to note about Parameshwaran and colleagues’ (2017) findings: medical students’ attitudes toward LGBTQ+ individuals were highly positive! Similarly, a study of Canadian healthcare professional students (in programs including medicine, nursing, clinical psychology, physiotherapy, and occupational therapy) found that they had highly positive attitudes toward trans individuals, specifically (McInnis et al., 2021). In fact, 56% of participants reported the maximum possible score on the measure of attitudes used in this study! These positive attitudes are promising, and suggest that healthcare professional students would be open to more education and training on working with LGBTQ2+ individuals generally, and trans individuals more specifically.

Here at QueeringCancer, we unfortunately don’t have the power to change university curricula. However, we are working on developing new pillar for our website, focused on providing resources for healthcare professionals. We recognize that there is a gap in education and training – our resources are here to help! And if you are a healthcare professional and have accessed resources that you have found helpful, we would love to hear about them!

References

McInnis, M. K., Gauvin, S. E. M., & Pukall, C. F. (2021). Transgender-specific factors related to healthcare professional students’ engagement in affirmative practice with LGBTQ+ clients. Psychology and Sexuality, 00(00), 1–13. https://doi.org/10.1080/194198…

Parameshwaran, V., Cockbain, B. C., Hillyard, M., & Price, J. R. (2017). Is the Lack of Specific Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students. Journal of Homosexuality, 64(3), 367–381. https://doi.org/10.1080/009183…

Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer, G. R. (2012). “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Services Research, 12(1), 110. https://doi.org/10.1186/1472-6…

Photo credit: Zachary Drucker The Gender Spectrum Collection

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