Assessing medical student perspectives on the complexity of sexual minority patients and implications for care

This article was originally published here

LGBT health. 2022 Apr 11. doi:10.1089/lgbt.2021.0023. Online ahead of print.


Goal: People belonging to sexual and gender minorities (SGM) experience many health care disparities. We sought to determine whether medical students consider patients from sexual minorities (lesbian, gay or bisexual [LGB] men/women) as more complex than heterosexual patients, even when presenting with the same symptoms, and whether this perceived complexity affects confidence in the management of LGB patients. Methods : A fictitious patient with an upper respiratory tract infection was presented with systematic variation in patient sexual orientation across six experimental conditions in an online vignette-based experimental study. Participants rated their perception of the patient’s medical, therapeutic, and social complexity and completed a measure of stigma towards SGM people. Finally, participants indicated their confidence in caring for the patient presented. Results: A total of 665 students participated. Participants considered LGB patients to be more complex in all areas, compared to heterosexual patients. Perceived medical and social complexity predicted less confidence in patient care. Participants reported lower confidence in caring for male homosexual patients with indirect effects of medical and social complexity. LGB identity was broadly and indirectly associated with lower trust due to social complexity. Conclusion: Our results suggest that students view LGB patients as more complex than heterosexual patients. Medical education programs should provide education on the effects of social bias on clinical judgments and care of LGB patients, as well as develop skills to build trust among LGB patients.

PMID:35404127 | DOI:10.1089/lgbt.2021.0023

Sharon D. Cole