Simulation Bridges LGBTQ+ Educational Gaps in Gynecologic Care: Menstrual Suppression for a Gender and Sexually Diverse Patient.

Introduction: LGBTQ+ patients have decreased access to culturally competent gynecologic care, which contributes to health care inequity. We designed an interdisciplinary educational initiative for improving gender and sexually diverse gynecologic care among OB/GYN residents.

Methods: Residents were given optional American College of Obstetricians and Gynecologists Modules on Transgender Care, a lecture about LGBTQ+ health issues, and a standardized patient simulation followed by a debrief. The case of a 25-year-old assigned female at birth (AFAB), nonbinary, pansexual patient (played by an AFAB nonbinary, pansexual individual) presented for menstrual suppression. Due to known provider discomfort in this setting, learners were assessed with postintervention surveys, rather than during the simulation, to help foster psychological safety.

Results: Pre- and postsurveys assessing LGBTQ+ competence and perceived helpfulness of the training were administered to 11 residents. Statistically significant increases (p < .05) were observed in comfort working with LGBTQ+ patients, knowledge regarding health needs for LGBTQ+ patients, comfort discussing sexual health practices with transgender/gender diverse patients, and confidence in ability to provide resources for LGBTQ+ patients. There were positive trends in reducing assumptions of a patient's gender identity and sexual orientation (p = .05), confidence asking a patient's name and pronouns (p = .06), supervising trainees caring for gender and sexually diverse patients (p = .07), and comfort using inclusive language (p = .08).

Discussion: Interdisciplinary education, including simulation, can increase resident confidence in providing gynecologic care for gender and sexually diverse patients, enhance cultural competence of providers, and help reduce inequities in LGBTQ+ gynecologic care.