Who treats matters: Elevating LGBTQI dermatology

Abstract

The LGBTQI community faces unique health challenges, particularly in dermatovenereology. LGBTQI patients often experience discrimination, refusal of healthcare or other negative healthcare experiences that may deter them from seeking professional care in the future.¹

Dermatology is one of the least ethnically and racially diverse specialties, second only to orthopaedic surgery—at least according to the only study we found based on US data.² This lack of diversity may contribute to the dermatologic community's limited awareness of the nuances faced by minority groups. This disparity has been highlighted by recent acknowledgements of gaps in medical education curricula regarding skin of colour.³ Additionally, 47% of dermatologists and residents report feeling insufficiently trained to diagnose diseases in skin of colour.⁴

Recognizing the sensitivity and controversy surrounding diversity and inclusion studies in medicine—especially given our own unsuccessful attempts to conduct dermatology diversity studies in Europe due to insufficient peer support—we deeply appreciate the significance of the work by Tsentemeidou et al.⁵

The study, the first of its kind in Europe, assessed 74 dermatologists-venereologists using the LGBT-Development of Clinical Skills Scale (DOCSS). Participants rated themselves moderately prepared to handle LGBT-specific dermatologic and venereological concerns, though there remains room for improvement. Specialists aged 45 and over reported less training and more conservative views regarding LGBT morality than their younger colleagues. This generational gap underscores the need for targeted continuing medical education to ensure all healthcare providers offer equitable and informed care.

Comparing these findings with scarce publications from other countries, it becomes evident that dermatovenereologists across the globe are more aware of attitudes and beliefs than they are prepared to handle real medical situations, emphasizing how LGBTQI-oriented education remains a global need in dermatology training. While Greece, a country generally considered to be both conservative and religious, demonstrates promise, bridging knowledge gaps and fostering inclusivity must continue to be priorities.

At a time when diversity, equity and inclusion initiatives face growing criticism, it is crucial to recognize their impact on patient care. Studies show that race-concordant visits improve patient satisfaction and perceptions of physician engagement. Minority physicians are more likely to serve their own communities, work in underserved areas and care for disadvantaged patients. In dermatology, increasing underrepresented physician representation could help reduce disparities in access to care and address the specialty's geographic maldistribution.

Integrating LGBT-specific training into residency and ongoing professional development programmes can significantly enhance healthcare outcomes. As dermatologists-venereologists are often among the first to identify signs of systemic conditions, improving their awareness and clinical skills benefits not only LGBT patients but also public health at large.

In conclusion, this study offers a hopeful perspective on advancing dermatological and venereological care for the LGBT community in Greece. Continued education, especially for older practitioners, and embedding inclusivity into medical training will be pivotal in achieving truly equitable healthcare.

None to declare.

None to declare.

The manuscript does not contain information or images relating to patients. It adheres to the ICMJE Recommendations for patient privacy.