LGBTQIA+ health teaching in undergraduate medical education: a scoping review

Introduction: LGBTQIA+ communities experience significant physical and emotional health disparities and are less likely to access healthcare services due to stigma and discrimination, yet inclusion of content about LGBTQIA+ communities in undergraduate medical education is not compulsory and varies substantially. Methods: A systematic scoping review was undertaken of papers published in English since 2014 describing teaching approaches and content in undergraduate medical education that specifically address LGBTQIA+ health. Results: A total of 2,393 articles was identified, of which 250 articles were assessed for full-text eligibility, leaving 59 included articles. Papers were analysed descriptively to chart the level, amount and nature of teaching on the topic and then analysed in terms of pedagogical and gender and sexuality diversity best practice. Most studies were from the United States and a handful of other Global North contexts. Most delivered content in the first year, with progressively less teaching each subsequent year. Almost half of the studies reported 2–6 hours of teaching time, combining didactic and practice-based modalities. The majority of included articles focused on attitudes, knowledge and skills in caring for LGBTQIA+ patients, with 22 focusing on transgender patients specifically. Several existing frameworks and theories were used for teaching LGBTQIA+ health. Conclusion: Better teaching of LGBTQIA+-related topics is required to improve medical education, particularly greater attention to intersex and disorders of sexual development (DSD), and historical and structural marginalisation of LGBTQIA+ people. Additionally, application of best practice, such as integrated spiral curricula, community-engaged curricula and discomfort and self-reflection in teaching towards deeper empathy and positive student attitudes, is suggested.