Mini masterclass - treating LGBTQI+ patients

Medical school equips doctors to do many things. Managing LGBTQI+ patients probably isn’t one of them.

Dr Asiel Adan Sanchez is a GP and clinical tutor at the university of Melbourne. He knows first-hand how clinical environments can be off putting for people who are queer, trans and gender diverse. He’s also created a solution for that called Wavelength - a learning tool that builds clinician skills and makes general practices safer for LGBTQI+ folk.

Dr Sanchez gives a quick masterclass on the simple and practical ways to take away the “awkward interactions” that occur in many medical environments. They say a very common example is when taking a sensitive history and asking about gender affirmation procedures.

“A lot of clinicians really struggle with asking those questions and often the language that they use is quite inappropriate. “ Have you had the operation?” for example. A patient might get this question all the time outside, in the real world, and if you don't explain to the patient what the rationale behind asking those questions is, it can be really distressing for them,” says Dr Sanchez.

Dr Sanchez provides a graduated approach to inquiring about gender affirmation surgery, after building rapport through simple ways such as using correct personal pronouns.

“I often tell medical students to fall back on the skills that they already have around cultural competency to build that rapport with the person. For example, you might be talking about work and family and what the patient does at home. Then you can ask “By the way, are there any pronouns that you'd like me to use?” And that's an organic and simple approach,” they say.

Dr Sanchez created the Wavelength training module in 2016 when he was a medical student at University of Melbourne. Wavelength is now managed by the Australian Medical Student Association (AMSA) who are advocating for Australian medical school curricula to include better LGBTQI+ health content.

Medical student Sophia Nicolades has researched the LGBTQI+ health curricula gap and found that the average hours of dedicated teaching was between zero and two hours across the medical whole degree.

“We found that the groups with the poorest health care outcomes were also the least present in our curriculars those being trans people, intersex people, bisexual people. and those with intersectional experiences such as First Nations people and folks with disability,” Mx Nicolades said.

Dineli Kalansuria, medical student and chair of AMSA Queer, is also working tirelessly to try and better the medical curriculum at Australian universities.

“We would also love for some practising doctors to take part in the Wavelength module and let us know if they feel that it's relevant, if it's representative of the presentations that they've been seeing as well,” she said

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