Medical students' perceptions of LGBTQ+ healthcare in Singapore and the United Kingdom

Michael X Fu; Tangming Zou; Raksha Aiyappan; Xinyu Ye; Simisola Onanuga; Angela Tan; Susan Smith; Ana Baptista

doi:10.3389/fmed.2023.1236715

Medical students' perceptions of LGBTQ+ healthcare in Singapore and the United Kingdom

Front Med (Lausanne). 2023 Oct 24:10:1236715. doi: 10.3389/fmed.2023.1236715. eCollection 2023.

Authors

Michael X Fu¹, Tangming Zou², Raksha Aiyappan², Xinyu Ye¹, Simisola Onanuga¹, Angela Tan², Susan Smith¹, Ana Baptista¹

Affiliations

¹ Medical Education Research Unit, Imperial College London, London, United Kingdom.
² Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.

Abstract

Introduction: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals have an increased scope of healthcare needs and face many barriers to accessing healthcare. However, LGBTQ+ healthcare education remains scarce, and students' understanding of LGBTQ+ healthcare remains largely uncharacterised. This study investigated the knowledge of and attitudes toward LGBTQ+ healthcare among medical students in Singapore and the United Kingdom (UK), two culturally different countries.

Methods: Medical students in two medical schools, one in Singapore and the other in the UK, completed self-administered cross-sectional surveys using multiple-choice, Likert scale, and free-text questions to explore their ideas, concerns, and expectations about LGBTQ+ healthcare education within their medical curricula.

Results: From 330 responses, students' knowledge levels were moderate overall, with pronounced gaps in certain areas, including terminology, sexual health, and conversion therapy. Deficiencies in knowledge were significantly greater among students in Singapore compared to the UK (p < 0.001), whilst LGBTQ+ students and non-religious students had more positive knowledge and attitudes than students not identifying. At least 78% of students had positive attitudes towards LGBTQ+ individuals, but 84% had not received LGBTQ+-specific medical education. Although junior UK students were more satisfied with the adequacy of teaching by their medical school's incorporation of LGBTQ+ inclusive teaching in a newer curriculum, qualitative analyses suggested that students in both countries wanted to receive more training. Students further suggested improvements to the medical curriculum to meet their needs.

Conclusion: Students in both schools lacked understanding of commonly-used terminology and topics such as sexual healthcare despite affirming attitudes towards LGBTQ+ healthcare. Although sociolegal contexts may affect students' perspectives, differences were less than thought, and students were equally keen to provide affirmative care to their patients. They emphasised a need for more formal teaching of LGBTQ+ healthcare professions to overcome healthcare disparities in these communities.

Keywords: LGBTQ+; attitudes; bias training; curriculum; medical education.

Grants and funding

This study was funded by the Professor Jenny Higham Collaboration Grant, a joint partner medical school grant supporting students to initiate and undertake innovative cross-border collaborations. MF additionally received an Imperial College Medical Education Research Unit Grant. The funding bodies had no role in study design, data collection, analysis, or the manuscript’s writing.