Pre-Departure Critique
In the Global Health Study Abroad Program, I will be partaking in research that focuses on the perceptions of medical students when providing healthcare to the LGBTQ population. There isn’t much research done on the perceptions and knowledge of Indian healthcare officials. This is why I am interested in finding out the biases and medical expertise of medical students when providing care to sexual minorities. There is a major health crisis in the LGBTQ community when trying to receive adequate care from physicians. The ability of healthcare providers to treat and diagnose sexual and gender minority patients can greatly impact their judgment when distinguishing risk factors.
There are millions of people who belong to the LGBTQ community in India and the United States. India and the United States vary greatly in their culture, religion, laws, and beliefs on gender. The United States bases gender on the gender binary model which places people into two categories which is male or female. In research, it is shown that people's beliefs in the gender binary reflect their attitudes and biases toward transgender people (Norton and Herek, 2013). However, in India, transgender people are known as hijras which is a third gender that is globally recognized. This group of people were born as men but present themselves as feminine individuals (Elischberger et al, 2017). Hijras is a marginalized community that faces discrimination, abuse, and unequal access to healthcare (Mal, 2018). The Indian healthcare system is centered on heterosexual individuals and places sexual minorities to the side. Being a part of the LGBTQ community poses risks and makes individuals vulnerable to mental and physical health issues (Majumder & Kar, 2021).
Healthcare professionals should be required to receive further training during their medical career to be able to interact positively and assist LGBTQ patients. It is a major concern for transgender patients to receive non-affirmative care from professionals. A curriculum on sexual and gender minorities is crucial in saving the lives of marginalized communities. The University of California, San Francisco School of Medicine has a program called Topic Steward that incorporates LGBTQ+ care, intersectionality, and sexual health into the curriculum. Topic Steward included courses on racial and ethnic health disparities. Group sessions, lectures, and workshops were centered around topics of LGBTQ health such as transgender surgery, hormone therapy, mental health, and pregnancies. This approach raised the amount of time spent on LGBTQ topics from 4.5 hours to 20 hours. It also recognized the gap in the curriculum and implemented ways to improve upon lessons on LGBTQ health (Raygani et al, 2022)
As I engage in research in India, I want to find out if there are any gaps in medical education when preparing students for their medical careers. To do so, I would interview medical students in Mysore about their medical curriculum and preparedness to treat and help LGBTQ patients. I would ask open-ended questions pertaining to coursework and if there are special lessons on the LGBTQ community. I would also like to know if they have any biases and preconceived notions when addressing sexual and gender minorities. Also, there would be surveys given to physicians to see their attitudes and inclination to help LGBTQ patients. A series of scales will be used. Some of the questions in the surveys include: (1) Are there opportunities in your workplace to discuss LGBTQA+ issues? (2) Rate your level of confidence when working with a client/customer who identifies as LGBTQA+?, (3) How confident do you feel taking a sexual history from an LGBTQ patient? It is possible that there may be some prejudice and transphobia present. It is important to bring awareness to these issues so that sexual minorities are able to receive sufficient healthcare. Getting the perspective of medical students and physicians in India will be a great start to finding solutions for healthcare officials and their patients.
Overall, I would like to pursue a career in immunology to become a research scientist. Although this research is psychological-based, I am interested in bringing awareness to health inequities in marginalized communities. In this field, I would be able to advocate for minorities to be able to participate in trials and receive proper access to medicine and care. This research would be instrumental in filling the gap in Indian healthcare regarding the knowledge and motivations of healthcare officials. The concern I have with exploring this research in India is opening the floor up to possible prejudice, homophobia, and transphobia. I know that it’ll be hard to get people to open up about their experiences in the medical field when treating sexual minorities.
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References
Elischberger, Glazier, J. J., Hill, E. D., & Verduzco-Baker, L. (2018). Attitudes Toward and Beliefs about Transgender Youth: A Cross-Cultural Comparison Between the United States and India. Sex Roles, 78(1-2), 142–160. https://doi.org/10.1007/s11199-017-0778-3
Majumder, & Kar, A. (2022). Primary healthcare for the Indian LGBTQ community - A call for inclusion. Journal of Gay & Lesbian Social Services, 34(4), 424–442. https://doi.org/10.1080/10538720.2021.2004285
Mal. (2018). The hijras of India: A marginal community with paradox sexual identity. Indian Journal of Social Psychiatry : Official Publication of Indian Association for Social Psychiatry, 34(1), 79–85. https://doi.org/10.4103/ijsp.ijsp_21_17
Norton, A. T., & Herek, G. M. (2013). Heterosexuals’ attitudes toward transgender people: Findings from a national probability sample of US adults. Sex Roles, 68, 738–753. doi:10.1007/s11199-011-0110-6.
Raygani, Mangosing, D., Clark, K. D., Luong, S., Flentje, A., & Sarah, G. (2022). Integrating LGBTQ+ health into medical education. The Clinical Teacher, 19(2), 166–171. https://doi.org/10.1111/tct.13463