Approaches to teaching gender and sexuality in undergraduate medical education : a scoping review

Introduction/Background The health of LGBTQIA+ people require substantial attention in undergraduate medical education. These communities experience significant health disparities and are less likely to access health care due to stigma and discrimination. Despite the importance, gaps exist in teaching LGBTQIA+ topics in medical schools worldwide. This study aims to understand current research describing LGBTQIA+ teaching content and pedagogical approaches in undergraduate medical education worldwide. Methods Arksey and O'Malley's five stage framework was followed for the scoping review. Database searches of MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), ERIC (ProQuest), and SCOPUS between 1 January 2000 and 5th September 2023 was conducted. Of the initially identified 2,393 articles, 59 were included in the review. Results The majority of articles were published in the USA with more than half published between 2020 and 2023. Most teaching activities allocated between one to six hours of teaching time, combining didactic curriculum with approaches such as patient panels, role-plays, case-based scenarios, and group discussions. Learning Objectives mostly fell within the first three levels of Bloom's taxonomyb: remember, understand and apply. Most teaching focused primarily on terminology, definitions and sexual history taking. More than a third of the included studies focused on transgender health. Discussion Findings illustrate diverse strategies in implementing LGBTQIA+ health curriculum. Despite a recent increase in gender and sexuality teaching, limited time is allocated to these topics, much of which is focused on the first year of medical training. Although foundational knowledge of LGBTQIA+ terminology and definitions of gender, sex, and sexual orientation are important, other critical learning aspects such as students' reflection of own values, empathetic and non - judgemental patient care remain largely overlooked. The dearth of published literature on LGBTQIA+ teaching from the Asia-Pacific, African and South American contexts raise questions of the uptake of these topics amongst medical schools in these regions.