Sarah Spiegel, a third-year med student at New York Medical College, is pushing for more comprehensive LGBTI health training.

After being disappointed in the brief information about LGBTI health given to her in her first year of med school, Spiegel decided to make a change.

By her second year, she became president of the school’s LGBT Advocacy in Medicine Club. Spiegel and a group of peers approached the administration about the lack of LGBTI content in the curriculum.

According to Spiegel, the administration was ‘amazingly receptive’ to the idea. Thus, the school went from an hour and half of LGBTI-focused content to seven hours. Spiegel does not think this change would have happened had the school’s LGBTI group not pushed for it.

Spiegel went on to join The American Medical Student Association’s Gender and Sexuality Committee as the LGBTQ Advocacy Coordinator. Her job in this role was to bring curricular change to other medical schools in the New York area.

Numerous studies have shown that medical schools do a poor job of training future doctors to understand the LGBTI population’s unique health needs. This is especially true when it comes to transgender and intersex people. A 2017 survey of students at Boston University School of Medicine found their knowledge of transgender and intersex health to be less than LGB health.

However, LGBTI people, especially transgender individuals, face a disproportionately high rate of mental illness, HIV, and other intersecting issues. A poll conducted by NPR found that 1 in 5 LGBTI adults have avoided medical care out of fear of discrimination.

‘The health of disparity populations is something that really should be the focus of health profession students,’ Dr. Madeline Deutsch, an associate professor at the University of California, San Francisco, tells NPR.

‘Sexual and gender minorities have historically been not viewed as a key population. That’s unfortunate because of the size of the population, and because of the extent of the disparities that the population faces.’

While the amount of time medical students spend on LGBTI-related issues varies, a 2011 study found the median amount of time spent on the topic was a mere five hours. Topics most frequently addressed were safe sex, sexual orientation, and gender identity. However, topics like gender transitioning weren’t often spoken of.

‘There’s not really a consistent curriculum that exists around this content,’ says Deutsch.

Activists doing the work

But with activists like Sarah Spiegel, LGBTI health is being spoken about more and more.

‘We’re getting there, but it’s slow,’ Spiegel tells NPR.