Liang Jennifer J, Gardner Ivy H, Walker Jacob A, Safer Joshua D
Endocr Pract. 2017 Aug;23(8):897-906. doi: 10.4158/EP171758.OR. Epub 2017 May 23.
Lesbian, gay, bisexual, transgender, and intersex (LGBTI) patients face many well-documented disparities in care which among transgender and intersex people can often be traced to providers' lack of knowledge.
We administered surveys to examine the self-assessed knowledge and attitudes of all medical students at Boston University regarding different LGBTI subpopulations. Survey questions were based on a Likert scale from 1 to 5; analysis was conducted with Wilcoxon rank sum tests.
Overall there was a response rate of 24%, with the number of responses varying by class. Three of the 4 surveyed classes reported lower knowledge about transgender health than LGB health. Every class reported significantly lower knowledge of intersex health in comparison to LGB. Comfort with transgender or with intersex patients was lower than with LGB patients for all surveyed classes. Students across all self-identified groups (LGBTI, ally, not an ally) reported significantly lower average responses for knowledge and comfort regarding transgender or intersex health in comparison to that of LGB. Students in their preclinical years reported lower levels of knowledge in comparison with students in their clinical years. Students who identified as LGBTI reported significantly higher knowledge and comfort with only LGB and transgender health when compared with students who didn't identify as LGBTI. Respondents more frequently requested additional learning opportunities in transgender and intersex health than in LGB health.
Self-reported knowledge of transgender and intersex health lags behind knowledge of LGB health, though these deficits appear partially responsive to targeted educational intervention.
BUSM = Boston University School of Medicine LGB = lesbian, gay, and bisexual LGBT = lesbian, gay, bisexual, and transgender LGBTI = lesbian, gay, bisexual, transgender, and intersex M1 = first-year medical student class M2 = second-year medical student class M3 = third-year medical student class M4 = fourth-year medical student class.
女同性恋、男同性恋、双性恋、跨性别者和双性人（LGBTI）患者在医疗保健方面面临诸多有充分记录的差异，在跨性别者和双性人当中，这些差异往往可归因于医疗服务提供者缺乏相关知识。
我们开展了调查，以检验波士顿大学所有医学生对不同LGBTI亚群体的自我评估知识和态度。调查问题基于1至5的李克特量表；采用威尔科克森秩和检验进行分析。
总体回复率为24%，回复数量因年级而异。在接受调查的4个班级中，有3个班级报告称对跨性别者健康的了解低于对LGB健康的了解。与LGB相比，每个班级报告称对双性人健康的了解明显更低。对于所有接受调查的班级而言，对跨性别者或双性人患者的接纳程度低于对LGB患者的接纳程度。所有自我认定群体（LGBTI、同盟者、非同盟者）的学生报告称，与LGB健康相比，他们对跨性别者或双性人健康的知识和接纳程度的平均回复明显更低。临床前几年的学生报告的知识水平低于临床阶段的学生。与未自我认定为LGBTI的学生相比，自我认定为LGBTI的学生报告称仅对LGB和跨性别者健康有明显更高的知识水平和接纳程度。与LGB健康相比，受访者更频繁地要求提供有关跨性别者和双性人健康的额外学习机会。
自我报告的跨性别者和双性人健康知识落后于LGB健康知识，不过这些不足似乎对有针对性的教育干预有一定反应。
BUSM = 波士顿大学医学院；LGB = 女同性恋、男同性恋和双性恋；LGBT = 女同性恋、男同性恋、双性恋和跨性别者；LGBTI = 女同性恋、男同性恋、双性恋、跨性别者和双性人；M1 = 一年级医学生班级；M2 = 二年级医学生班级；M3 = 三年级医学生班级；M4 = 四年级医学生班级。
