AAMC Releases Health Care Guidelines For Patients That Are LGBT, Gender Nonconforming, Or Born With Differences Of Sex Development

The AAMC (Association of American Medical Colleges) has released the first guidelines for training physicians to care for people who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming, or born with differences of sex development (DSD). Until now, there have been no formal comprehensive standards to help medical schools and health care organizations train providers in the health care needs of these patients.

Boston’s Jennifer Potter, MD, Director of Women’s Health at Fenway Health and Director of Women’s Health Education at Beth Israel Deaconess Medical Center, played a key role in shaping these guidelines as a member of the AAMC Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development.

“This groundbreaking publication represents a major step forward in giving medical schools, teaching hospitals, and health systems a roadmap for improving the care of LGBT and other individuals with differences in gender identity, gender expression, and sex development,” said Darrell G. Kirch, M.D., AAMC president and CEO.

People who are LGBT, gender nonconforming, or born with DSD often experience challenges when seeking care in doctors’ offices, community clinics, hospitals, and emergency rooms. These experiences, which can range from being made to feel unwelcome to outright discrimination and mistreatment, lead to poorer physical and emotional health.

The report identifies 30 competencies that physicians must master. These competencies fall under eight domains of care critical to training physicians, including patient care, knowledge for practice, practice-based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice, interprofessional collaboration, and personal and professional development. This competency-based framework will allow medical educators to integrate the new guidelines into existing curricula more easily and encourage faculty and health care professionals to move away from thinking of patients in these groups as separate from the general patient population.

“Shortfalls in health professional training need to be corrected in order to address the gaps in care that lead to health inequities among people who are LGBT or born with DSD . Until now, many schools simply have not known how to approach this undertaking,” said Jennifer Potter, MD. “This report outlines much-needed educational guidelines that will work in medical schools, but can also be easily adapted to training programs for nurses, physicians assistants, and other health professionals.”

The AAMC has long recognized the needs of gender and sexual minorities as a priority, calling in 2007 for member institutions to ensure that faculty and new medical school graduates “treat each patient with dignity and respect, regardless of the patient’s sexual orientation or gender identity,” and to “respond effectively, compassionately, and professionally to the needs of all patients.” In 2012, with funding from the Josiah Macy Jr. Foundation, the AAMC convened an Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development comprising medical education experts—including physicians who provide direct patient care—to develop a set of consensus-driven educational goals to directly address issues of sex, sexuality, and gender-related clinical care. The new competency guidelines are the result of this work. The Committee is currently developing a curriculum integration workshop that will be piloted at the University of Louisville School of Medicine in 2015.

“Physicians and medical school faculty members are committed to treating all patients equally, yet research shows that everyone has unconscious biases that can affect how we interact with people from different experiences and backgrounds,” said Kirch. “This new resource will help train physicians to overcome these blind spots and deliver high-quality care to all patients.”

To download the publication: http://offers.aamc.org/lgbt-dsd-health

To view a video highlighting ongoing work to ensure medical providers have the knowledge and skills required to deliver high-quality care to people who are LGBT, gender nonconforming, or born with DSD: https://vimeo.com/111221510

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