Table 3.
Medical student self-reported comfort and competence, individual survey items on AAMC competencies.
| Comfort Items | Number of Respondents N (%) |
|||
|---|---|---|---|---|
| Not comfortable | Somewhat not comfortable | Somewhat comfortable | Very comfortable | |
| Treat sexual minority (e.g., queer, bisexual, lesbian, gay) patients | 9 (1.4) | 39 (5.9) | 234 (35.6) | 375 (57.1) |
| Treat gender minority (e.g., transmasculine, transfeminine, genderqueer) patients | 40 (6.1) | 168 (25.6) | 281 (42.8) | 168 (25.6) |
| Discussing sexual orientation (that is, an individual’s sexual attraction, sexual partners, and sexual orientation identity, such as LGBQ) with patients | 17 (2.6) | 71 (10.8) | 231 (35.1) | 339 (51.5) |
| Discussing sexual practices with sexual and gender minority patients (e.g., bottom/top, sex toy use, dental dam use) | 67 (10.2) | 184 (28.0) | 237 (36.0) | 170 (25.8) |
| Discussing gender identity (that is, individuals’ internal perception or sense of their own gender) with patients | 34 (5.2) | 141 (21.5) | 236 (36.0) | 244 (37.3) |
| Discussing sexual and gender minority-specific health topics (e.g., hormone therapy, reciprocal in vitro fertilization, safe sex practices for sexual minorities) |
78 (11.9) |
191 (29.2) |
214 (32.7) |
172 (26.3) |
| Number of Respondents N (%) |
||||
| Competence Items |
Not competent |
Somewhat not competent |
Somewhat competent |
Very competent |
| Sensitively interview patients about sexual orientation, sexual history, and sexual practices | 17 (2.6) | 86 (13.1) | 295 (44.7) | 262 (39.7) |
| Sensitively interview transgender and GNC patients about their gender identities, health and risk behaviors, and physical anatomy | 71 (10.8) | 221 (33.7) | 249 (37.8) | 118 (17.9) |
| Describe treatment options for transgender patients, including pre-pubertal hormone block, hormone therapy and surgeries | 281(42.7) | 225 (34.0) | 102 (15.4) | 53 (8.0) |
| Describe treatment options for patients born with DSD, differentiating between elective and non-elective therapies and surgeries for the most common DSD conditions | 316 (47.8) | 219 (33.2) | 85 (12.9) | 40 (6.1) |
| Describe key screening recommendations for sexual and gender minorities | 184 (27.8) | 221 (33.4) | 178 (26.9) | 78 (11.8) |
| Define and describe the differences between the following: sex and gender; gender expression and gender identity; and between gender discordance, gender nonconformity and gender dysphoria | 65 (9.9) | 170 (25.9) | 229 (34.9) | 193 (29.4) |
| Describe etiologies of atypical sex development | 168 (25.5) | 235 (35.7) | 179 (27.1) | 77 (11.7) |
| Describe historical, political, sociocultural, and institutional factors that contribute to the development and maintenance of health disparities among LGBTQ patients, GNC patients and patients born with DSD, including historical and current provider practices (e.g., reparative therapy) | 130 (19.7) | 249 (37.8) | 182 (27.6) | 98 (14.9) |
| Identify and address communication patterns in the health care setting that adversely affect care of LGBTQ, GNC, and DSD patients | 96 (14.6) | 219 (33.2) | 231(35.1) | 113 (17.2) |
| Describe how patients’ and families’ healing traditions and beliefs might shape reactions to diverse forms of sexuality, sexual behavior/orientation, gender identity, gender expression, and sex development | 88 (13.4) | 195 (29.6) | 257 (39.0) | 119 (18.1) |
| Employ appropriate consent and assent practices for disclosure of gender, sexuality, and sex issues in a clinical setting | 100 (15.2) | 195 (29.7) | 222 (33.8) | 140 (21.3) |
| Describe the special challenges faced by health professionals who identify with one or more of the following populations: LGBTQ, GNC, DSD | 104 (15.9) | 223 (34.0) | 219 (33.4) | 110 (16.8) |
| Describes the strategies that can be used to enact reform within existing health care institutions to improve care to LGBTQ, GNC, and DSD patients | 150 (22.9) | 267 (40.7) | 173 (26.4) | 66 (10.1) |
| Describe the special legal and policy issues that affect LGBTQ, GNC, and DSD patients | 163 (24.8) | 253 (38.5) | 170 (25.8) | 72 (10.9) |
| Identify your own implicit biases which impact the care delivered to LGBTQ, GNC, and DSD patients and develop strategies to mitigate their impact | 31 (4.7) | 139 (21.2) | 317 (48.2) | 171 (26.0) |