Characterization of Knowledge, Attitudes, Comfort, and Perception of Discrimination Regarding Sexual and/or Gender Minoritized People: Comparison Between Two Cohorts of Medical Students - 2018-2023.

Abstract

Objectives: Despite progress made in the medical field to address the health concerns of sexual and gender minoritized identities, LGBTQIA+ individuals continue to experience discrimination in healthcare. This study aims to evaluate the effects of incorporating a seminar on gender identity and sexual orientation into the medical curriculum of a Portuguese Medical School, after 5 years. The study's main objective was to compare the changes in students' knowledge, attitudes, comfort, and perception of discrimination against LGBTQIA+, pre and post-intervention.

Methods: A total of 313 students in their third, fourth, fifth, and sixth year at a Portuguese Medical School were assessed in 2018 (pre-intervention) and 2023 (post-intervention). The data collected were analyzed regarding age, gender identity, sexual orientation, number of friends or family members who identify themselves as LGBTQIA+, and level of religiosity.

Results: The overall knowledge regarding LGBTQIA+ people specific health aspects improved from the 2018 cohort to the 2023 cohort, with significant differences in questions regarding gender identity (OR = 2.0, p = .007), sexual orientation (OR = 2.9, p <.001), and mental health (OR = 3.2, p <.001). The perceived discrimination against homosexual patients was similar in both cohorts, with approximately 60% of respondents from both groups agreeing that homosexual patients were discriminated against in healthcare.

Conclusion: Although the perception of discrimination against LGBTQIA+ people in healthcare remained high across the two cohorts, positive changes were observed regarding students' overall knowledge of LGBTQIA+ individuals' health, clinical preparation and comfort in treating LGBTQIA+ people, and attitudes toward lesbian women and gay men. These results reinforce the need to develop training and information strategies targeting medical students, promoting greater knowledge and, above all, increasing contact and clinical practice with LGBTQIA+ people, since relationships and personal contact are the most differentiating aspects for nondiscrimination.