ReviewThe inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review
Introduction
To be more fully inclusive of the range of sexual and gender identities, including groups such as asexual, intersex, questioning and queer, the contemporary umbrella term LGBT+ is now being more widely adopted (Formby, 2017; Fredriksen-Goldsen, 2016). This is the term used throughout this paper.
There is a global interest in providing access to adequate healthcare for all (Australian Human Rights Commission, 2014; Department of Health, 2013; Ontario Human Rights Commission, 2014), and to specific groups such as people whom identify as lesbian, gay, bisexual (Institute of Medicine, 2011; Royal College of Nursing, 2016; Royal College of Nursing, 2017; World Health Organisation, 2013). However, while this is laudable, there remains significant gaps, in for example, the research evidence-base focusing on the distinct needs of people who are transgender and intersex. This is despite the existing concerns around social inclusion, human rights, discrimination and marginalisation (McCann and Brown, 2017) and the challenges and negative attitudes faced by LGBT+ people when accessing and using health services (Dearing and Hequembourg, 2014; Mayock et al., 2008; Stewart and O'Reilly, 2017).
Section snippets
Background
There is clear evidence of the distinct health needs and service requirements of people whom identify as LGBT+. Physical health needs include sexually transmitted infections (STIs) including Human immuno-deficiency virus (HIV), hepatitis (Cahill and Makadon, 2013; The Royal College of General Practitioners (Northern Ireland), 2015). Mental health conditions are also prevalent such as anxiety, depression, self-harm, suicidal ideation, attempted suicide and drug and alcohol use (King et al., 2008
Aim
The aim of this systematic review was to identify the educational needs of undergraduate students and health professionals and the approaches used in their education in relation to people who identify as LGBT+. The review questions were:
- 1.
What are the education and training requirements of undergraduate students and health professionals regarding the needs of LGBT+ people?
- 2.
What are the approaches utilized in the education and training of undergraduate students and health professionals regarding
Findings
The aim of this systematic review was to consider the literature around the education of undergraduate students and the training of health professionals in relation to people whom identify as LGBT+. Following analysis of the included studies, four main themes emerged from the data: (1) Cultural competence and inclusivity. (2) Existing knowledge of LGBT+ health-related issues. (3) Curriculum developments and outcomes. (4) Evidence of best practice in education delivery and evaluation. Each theme
Discussion
In many countries across the world there have been major legislative developments that have recognised and strengthened the position of LGBT+ people (World Health Organisation, 2013). These advancements have enshrined within legislation the fundamental human rights and equality directives necessary to tackle discrimination, marginalisation and social exclusion. The positive legislative developments include human rights, civil partnership, marriage equality, adoption and fostering (Henry and
Strengths and Limitations
This systematic review has identified important issues that need to be addressed to ensure that undergraduate students and health practitioners possess the appropriate knowledge, skills, attitudes and values necessary to meet the distinct health needs of LGBT+ people. Tools have been developed to assist educators, undergraduate students and practitioners to identify areas related to LGBT+ health where further development is required. The identification of areas of best practice about LGBT+
Conclusion
There are examples of the inclusion and integration of LGBT+ health needs and concerns within undergraduate health curriculum and CPD programmes for practitioners. This is encouraging and necessary given the significant health inequalities and distinct needs experienced by this population. There are examples of best practice in the delivery and evaluation of LGBT+ health within education programmes that offer a helpful starting point to guide developments more widely. It is also apparent from
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author Contributions
EM and MB designed the review, conducted searches, critical appraisal and analysis of the data. Both authors reviewed drafts and prepared and finalised the review for publication.
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