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A 'teachable moment' in LGBT health

Our campus, our community and our country have been gripped in recent months by the harrowing number of gay teen suicides reported in the media.

The topic has been difficult to ignore, and rightly so. Teen bullying has been a real problem in our schools, particularly against LGBT teens. Almost nine out of 10 LGBT teens have experienced harassment in the past year, and LGBT teens are at a higher risk for suicidal consideration or attempts.

While anti-bullying efforts and gay-straight alliances are essential to fixing the problem, there is a critical responsibility here for physicians and other health care providers as well.

It’s not just about bullying: There are other aspects of health being affected, even into college and adulthood. LGBT teens are more likely to report depression, anxiety, risky sexual behavior, substance use and eating disorders.

Physicians need to be ready to detect and handle these problems, as they hold the privilege to ask anything in confidence from a teen patient, like sexual orientation or gender identity. Yet 65 percent of LGBT teens are not out to their physicians. Further, 68 percent of respondents in a Washington, D.C. pediatrician survey said they do not usually ask about sexual orientation.

These are missed opportunities for potentially life-saving health education and counseling to help LGBT teens explore their feelings and handle the stressors that come with stigmatization. And one obstacle is the lack of training.

To address this, a group at Stanford has been conducting the LGBT Medical Education Assessment to determine what’s being taught at medical schools in LGBT health.

For example, the University of California at San Francisco School of Medicine has instituted “infusions” of LGBT-related material across its curriculum in the form of clinical cases, standardized patients and a required three-hour training for second-years.

Closer to home, the UNC School of Medicine has been stepping up slowly but surely. Primarily through efforts of the Queer Straight Alliance, students have organized LGBT health weeks, SafeZone trainings for health care providers and a fourth-year capstone session.

Though commendable, these events have remained solely voluntary, thus reaching only a fraction of medical students.

Until we demand, develop and require a systematic inclusion of LGBT medical education at UNC and other schools, we will not be able to train our doctors to serve the 8.8 million LGBT people in the U.S., including LGBT youth.

Dr. Georgette Dent, associate dean of student affairs at the UNC medical school, agrees: “LGBT individuals are members of a medically underserved community. It’s important to train future physicians to do a better job of meeting the health care needs of this population.”

This next generation could lead the charge to improve the health and well-being of all LGBT teens (later, LGBT adults), if they only knew how.

As Richard Socarides, former LGBT adviser to President Bill Clinton, told the Associated Press, we can make this “tragedy into a teachable moment.”

It’s our moment, so let’s start teaching.

Perry Tsai is a second year medical student from New Orleans, LA. Contact him at perrytsai@gmail.com

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