Welcome to the LGBT Health Interest Group of Washington University in St. Louis School of Medicine! We are a group of medical students dedicated to addressing the health care needs of lesbian, gay, bisexual, and transgender patients and physicians. We hope this site is useful to you as current students, students networking from other medical schools, or prospective students to our own medical school.
Take a look around and contact us if you have any questions or are interested in our events!
Matt Zinter, WUSM c/o 2011
2007-2009 Student Leader
Leslie Chiang, WUSM c/o 2014
2010-2012 Student Leader
The mission of the LGBT Health Interest Group is to improve healthcare for lesbian, gay, bisexual, transgender patients. We work towards this goal by educating medical students on health disparities in this population and the many factors that affect their access to care as well as their quality of care. We also train medical students in ways to make healthcare settings a safe zone and ways to build trust in the physician-patient relationship.
By helping future WUSM physicians become more comfortable with LGBT patients and knowledgeable about LGBT health issues, we hope to eliminate the many health disparities facing LGBT patients.
Why is medical student education on LGBT patients important?
- Patient Outcomes: Negative interactions with primary care physicians are a leading cause for patients to terminate care. For example, one study in the Journal of General Internal Medicine found that 77% of lesbians reported negative interactions with their PCP and 33% actually terminated care due to discomfort, perceived discrimination, or actual discrimination (ref). Patients who feel uncomfortable with their doctor are less likely to disclose a history of hate crimes, economic dislocation, mental health difficulties, substance abuse, and domestic violence. They are also more likely to delay medical treatment. All of these factors result in reduced health outcomes.
- Professional Responsibility: The patient has given us the honor and responsibility to look, touch, poke, prod, ask, and record. In exchange, we vow beneficence, nonmaleficence, respect for autonomy, and distributive justice. That means we have a professional duty to provide the best care possible to patients.
- Human Rights: Every patient, colleague, and coworker deserves freedom from discrimination and freedom from undue burden of psychological stressors. Learning about LGBT patients and the many factors that affect their lives can open minds and hearts, and ultimately help combat prejudice & discrimination.
Special thanks to Dean Leslie Kahl, MD; Dean Alison Whelan, MD; Dean Ed Dodson, MD; and Diane Smith in Room 100 for their support!
LGBT Mental Health Awareness Panel
Depression, suicide, eating disorders, body image, and substance abuse are all significantly elevated in the LGBT community. We invite a panel of psychiatrists, psychologists, youth support group leaders, and community activists to help:
Review the epidemiology and statistics that help quantify the seriousness of these mental health disparities.
Explain the etiology behind why LGBT patients are at increased risk for developing mental health conditions.
Biological factors (there are NONE! LGBT mental health disparities are due to social and cultural factors)
Cultural factors (body culture, socialization through bars, parenting dilemma, gender bipolarity, the intersection between homophobia and sexism)
Disclosure (psychological adjustment to new identity, family conflicts, economic dislocation, lack of social support)
Prejudice & discrimination (employment / housing / insurance discrimination, hate crimes)
Concealed identity (reluctance to seek medical care, delayed treatment, lack of preventative care, incomplete medical history)
Describe what the future physician can do to help future LGBT patients who may be facing mental health conditions.
Click here to download our LGBT Mental Health Disparities fact sheet.
Our goals for this event are to use TV and movie clips to introduce situations involving LGBT people in clinical settings ...
where such difficult situations require skill and sensitivity to properly navigate
where such difficult situations may affect patient care
where such difficult situations may affect workplace dynamics
... and are thus worthy of discussion. We also use TV and movie clips to discuss & dispel common myths about LGBT people. Some of the clips we've chosen depict:
A straight male doctor sexually harasses a lesbian resident (ER)
Transgender transitioning (The L Word)
A gay partner and an estranged family conflict over rights to end-of-life decision-making for a dying man (ER)
Race, Gender, & Sexuality: The Down-Low
Professor Adele Morrison (faculty profile) shares a public health and epidemiological perspective regarding this unique and historically overlooked trend in the spread of sexually transmitted infections, particularly HIV. The clinical value comes in our understanding of the context under which many African American and Hispanic men make decisions about sexual practice and disclose personal health information. We explore the following questions:
The Down-Low: What is it? Are there similar phenomena? Why is it socially and clinically important?
What is the history of African Americans in the LGBT community? How have they been a part of the LGBT community? How have they been excluded?
What is the difference between gay, MSM, and same-gender-loving? Why do some people choose one label, others choose a different label, and some people choose no label at all?
Gender Identity & Transgender Health Discussion Group
The 1st year Practice of Medicine curriculum includes a 1.5 hour session in which a transgender faculty member shares her experience transitioning and also elaborates on topics in gender identity. Student feedback has been very positive but has indicated a desire for more time to process & discuss this presentation. We have developed this lunch discussion group for the day following that lecture. No extra knowledge is required to attend and there are no incorrect answers or stupid questions. We break into small groups with a 2nd year facilitator to discuss the presentation and the following questions:
When did you realize your own feelings of gender identity and how did you know?
How do you think your own friends and family would react if you told them your internal feelings of gender identity don’t match your physiological sex? Why might they act that way?
What difficulties do you foresee in a transgendered individual participating in public ADL’s (activities of daily living) such as using public restrooms, swimming in public, clothes shopping, etc?
Despite superficial and/or surgical changes, MTF individuals still need prostate screenings and FTM individuals still need mammograms. Obviously, insurance companies do not cover prostate screenings for women, nor do they cover mammograms for men. As a provider, how do you work with your patient to ensure they have (1) access to care and (2) fair insurance coverage, while avoiding unnecessary disclosure or compromising privacy?
You are a MTF transgendered individual who has not legally changed your male gender to match your female gender identity and the female clothes you wear. You are seated in the waiting room when the nurse comes in and says “Mr. Smith?” Do you stand up and risk stares and public confusion? Do you stay seated and come forward later? What do you do?
What are the pros and cons of surgically changing your sex?
What are the pros and cons of legally changing your name or gender?
If you were a transgendered individual living according to your gender identity (not your biological sex) and you are in a new relationship, would you tell your date that you are transgendered early in the course of your relationship or would you tell your date later in the course of your relationship? What is fairest to you? What is fairest to your date?
Click here to download thoughts on these questions. There are no right answers!
Practice of Medicine 1
Our group collaborates with the POM Office to recruit speakers for the 1st year Sexual Orientation session. We also facilitate the question-and-answer session at the end of the day.
The goals for this event are:
- Learn how to react if someone comes out to YOU
- Help establish your social & professional environment as a SAFE ZONE
- Learn how to respond if someone says something inappropriate.
- Generalize these principles to ALL types of diversity
We have three 30-minute modules through which participants rotate:
- Spectrum Activity
- The group ranks a number of behaviors / actions / statements along a spectrum from appropriate to highly offensive.
- The group then discusses why they ranked some things as more offensive and others as less offensive.
- Exploration of societal status quo will occur when the group is forced to discuss whether being racist is “worse” than being homophobic. In addition, is committing an action “worse” than just having the intent? Is talk less harmful than action?
- The discussion will help the group evaluate where societal change needs to occur.
- Role Playing
- You overhear someone making a sexist comment.
- A colleague comes out to you. What’s the best way to respond?
- You enter an exam room to evaluate Abby Smith and you see a masculine-looking individual dressed in men’s clothes in the room. You confirm that you have the correct patient and suspect he may be transgendered. How do you proceed?
- You enter an exam room to find that your patient does not want you, a (insert minority) to be his doctor. You suspect overt racism / sexism / homophobia.
Defining Our Community
- Participants will have the opportunity to role-play each scenario in order to practice different methods and experience these difficult situations. If they get stuck, they can “tap-out” and swap places with another participant.
- Participants will use wireless voting devices to anonymously respond to evocative questions.
- Have you ever been a victim of ____?
- Have you ever witnessed an incident of ____?
- Have you ever vocally opposed an incident of ____ right when you saw/heard it happen?
- Have you ever missed an opportunity to vocally oppose an incident of ____?
- Which of the following reasons expresses why you missed that opportunity?
- By quantifying our collective experiences, we dispel myths about our environment and encounters. We may think we were the only one who had experienced ____ but actually many people have! Or … we may be surprised by how many/few people have experienced ____. A discussion will follow.
InterACT is an acting troupe from University of Missouri - St. Louis who perform interactive social justice theatre. They have been gracious enough to custom-write a skit for us that deals with multiple issues of sexual orientation, gender identity, sexism, and heterosexism. After they perform the skit, the audience has an opportunity to ask the characters questions regarding their thoughts, feelings, motives, and relationships with the other characters. Then the troupe re-performs the skit, but this time audience members can pause the action, influence the characters, and change the results. It's a GREAT way to problem solve on-the-spot and address a number of LGBT-related topics that occur in social environments.
Click here for the InterACT homepage.
Happy Hour Social
We've hosted a number of informal events with other graduate schools, including a meet & greet, a happy hour, and a bar night.
We have purchased Rainbow Caducei for white coats so that future patients can easily identify their medical student or doctor as an ally to whom they can disclose sensitive, medically important information without risking betrayal. We have also purchased Straight But Not Narrow backpack buttons in an attempt to make our medical campus a more prominent safe zone. To purchase these for you or your school, click here.
Contact Leslie Chiang here.