Lack of education for doctors on LGBTQ health 'medically harmful,' researchers warn

All medical students in Canada need to learn about LGBTQ health through a mandated, standardized curriculum, say advocates and researchers. 

Right now, LGBTQ health education in Canadian medical schools is limited and inconsistent, according to a recent article in the Canadian Medical Association Journal (CMAJ).

This means a lack of knowledge and awareness among doctors and negative and uncomfortable experiences for LGBTQ patients, says Miranda Schreiber, the lead author and a University of Toronto health researcher who is a member of the LGBTQ community herself. 

They're less likely to go again, even if they need care, she says.

"It's not just that doctors are intentionally discriminating against patients from our communities, but that the education is around this hetero-normative standard," said Schreiber in an interview with CBC Toronto.

"It's a pretty universal experience that is ultimately quite medically harmful." 

She says experiences range from "kind of funny" — instead of asking if she had a girlfriend or sexual partner, her doctor awkwardly inquired if she had a "pal" — to frustrating.

She points to a 2014 study that found lesbians were overlooked for routine pap smears because they don't have male sexual partners, putting them at risk for undetected cervical cancer.

Federal committee recommends more education

A 2019 report from the House of Commons Standing Committee on Health found that LGBTQ people experience worse health outcomes than their heterosexual counterparts and disproportionate rates of cancer, chronic fatigue and heart disease.

They're less likely to have a family doctor and more likely to live with chronic conditions, as well as experience poor mental health and substance-use disorders. 

One of the standing committee's recommendations was for health professionals to receive more training on LGBTQ health to better meet their needs.

A national survey of Canadian medical students found that only 10 per cent felt knowledgeable enough to provide health care to transgender patients, the CMAJ article says.

Research has shown even a few hours of education has resulted in doctors taking better notes about a patient's sexual history, providing more comprehensive preventative health counselling and showing fewer signs of prejudice during intake interviews. 

Online petition sees nearly 1,500 signatures

An online petition calling for standardized LGBTQ medical education has received close to 1,500 signatures in two weeks. It requests collaboration from the Association of Faculties of Medicine, the College of Family Physicians and the Royal College of Physicians and Surgeons. 

SexMed, an advocacy group dedicated to combating sexual health inequalities, launched the petition.

"As there are no standards set on what medical students need to know by the medical associations in charge, medical schools don't have any accountability in terms of what they need to teach regarding 2SLGBTQIA+ health," said founder and CEO Jillian Schneidman, a McGill medical student. 

Of the three associations, only the Royal College has provided a comment to CBC News so far.

Spokesperson Janis Hass says the college has already established standards for "respecting all patients and considering their contexts in care." 

When the Royal College updates its competency framework for 2025, Hass says it will consult with stakeholders "to ensure greater emphasis on equity, diversity and inclusion, LGBTQ2+, anti-Black racism, and Indigenous health issues."

SexMed's health equity promoter Sarah Robinson says while the associations have not responded to the petition, several medical school student associations have shown their support on campuses.

A spokesperson from the University of Toronto's Faculty of Medicine says it has "made a good deal of progress" revising its curriculum to teach students about caring for LGBTQ patients. 

The medical school says it also held a LGBTQ health workshop in 2020 that better prepared early-career physicians.