Intended for healthcare professionals

Rapid response to:

Practice Practice Pointer

Safeguarding LGBT+ adolescents

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l245 (Published 31 January 2019) Cite this as: BMJ 2019;364:l245

Linked Opinion

NHS staff are in a perfect position to be advocates for LGBT+ people when they most need it

Rapid Response:

Re: Safeguarding LGBT+ adolescents

This article highlights the very real consequences of under-serving LGBT+ patients, and suggests pragmatic approaches to better address the needs of this population. However, education about inclusion needs to start at medical school to incorporate inclusive thinking from the beginning of shaping new doctors. When reflecting on current classroom and clinical learning experiences, this is almost entirely missing in today’s medical school curriculum.

The most recent Stonewall report on the treatment of LGBT+ people in healthcare found that almost a quarter of NHS staff have witnessed negative attitude towards LGBT+ people (1). Perhaps even more worrying is that 1 in 20 have witnessed poorer care delivered to patients based on their sexuality (1).

Currently, LGBT+ education at medical school does not go beyond reducing sexuality to a risk factor for STIs; medical students are conditioned to assume HIV-related immunosuppression when reading a scenario with an MSM patient for a multiple choice question and to therefore assume any purple rash is Kaposi’s sarcoma, or pulmonary symptoms are due to PJP. Although it is important to consider the risk of certain sexual behaviours, the absence of any other training on the needs of LGBT+ patients skews attitudes and perpetuates negative stereotypes.

Medical students need to be exposed to a diverse range of LGBT+ patient experiences. Instead of MSM being synonymous with promiscuity, learning how to consider the various social and economic struggles that will affect their health would be more helpful.

UK curricula need to address the deficit and include teaching in both preclinical and clinical stages of education, as suggested in this article. This will ultimately lead to both a more diverse workplace with less discrimination, as well as better patient care, bringing us a step closer to the NHS’ goal of serving each and everyone of us.

(1) Somerville C. (2015). Unhealthy Attitudes. The treatment of LGBT people within health and social care services. Stonewall.

Competing interests: No competing interests

03 February 2019
Jeremias LK Reich
Medical Student
Kanay Khakhria
Imperial College London
London, SW7 2AZ