Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey | BMC Medical Education

  • Shires DA, Jaffee K. Factors associated with health care discrimination experiences among a national sample of female-to-male transgender individuals. Health Soc Work. 2015;40(2):134–41.

    Article 

    Google Scholar 

  • Grant J, Mottet L, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. 2010.

    Google Scholar 

  • James S, Herman J, Rankin S, Keisling M, Mottet L, Anafi Ma L. The report of the 2015 US transgender survey. 2016.

    Google Scholar 

  • Enson S. Causes and consequences of heteronormativity in healthcare and education. Br J Sch Nurs. 2015;10(2):73–8.

    Article 

    Google Scholar 

  • Ayhan CHB, Bilgin H, Uluman OT, Sukut O, Yilmaz S, Buzlu S. A systematic review of the discrimination against sexual and gender minority in health care settings. Int J Health Serv. 2020;50(1):44–61.

    Article 

    Google Scholar 

  • Cicero EC, Reisner SL, Silva SG, Merwin EI, Humphreys JC. Health care experiences of transgender adults: an integrated mixed research literature review. ANS Adv Nurs Sci. 2019;42(2):123–38.

    Article 

    Google Scholar 

  • Ross MH, Setchell J. People who identify as LGBTIQ+ can experience assumptions, discomfort, some discrimination, and a lack of knowledge while attending physiotherapy: a survey. J Physiother. 2019;65(2):99–105.

    Article 

    Google Scholar 

  • Krehely J. How to close the LGBT health disparities gap. Center for American Progress. 2009;1(9):1–4.

    Google Scholar 

  • Bauer GR, Scheim AI, Deutsch MB, Massarella C. Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey. Ann Emerg Med. 2014;63(6):713–20.

    Article 

    Google Scholar 

  • Lee A, Kanji Z. Queering the health care system: experiences of the lesbian, gay, bisexual, transgender community. Can J Dental Hygiene. 2017;51(2):80–9.

    Google Scholar 

  • Ross MH, Hammond J, Bezner J, et al. An Exploration of the Experiences of Physical Therapists Who Identify as LGBTQIA+: Navigating Sexual Orientation and Gender Identity in Clinical, Academic, and Professional Roles. Phys Ther. 2022;102(3):pzab280.

    Article 

    Google Scholar 

  • Ravi R, Cheng S, Hutter J, et al. A Call to Disrupt Heteronormativity and Cisnormativity in Physical Therapy: Perspectives of 2SLGBTQIPA+ Participants on Future Directions for PT Curricula. Physiother Can. 2022:e20220019.

  • Copti N, Shahriari R, Wanek L, Fitzsimmons A. Lesbian, gay, bisexual, and transgender inclusion in physical therapy: Advocating for cultural competency in physical therapist education across the United States. J Phys Ther Educ. 2016;30(4):11–6.

    Article 

    Google Scholar 

  • Primeau CA, Vader K, Philpott HT, Xiong Y. A Need for Greater Emphasis on 2SLGBTQIA+ Health Among Physiotherapists in Canada. In. Vol 74: University of Toronto Press; 2022. p. 117–120.

  • Canadian Council of Physiotherapy University Programs. National Physiotherapy Entry-to-Practice Curriculum Guidelines. 2019. Available at: https://www.peac-aepc.ca/pdfs/Resources/Competency%20Profiles/CCPUP%20Curriculum%20Guidelines%202019.pdf. Accessed on 13 Oct 2021.

  • Sherman ADF, Cimino AN, Clark KD, Smith K, Klepper M, Bower KM. LGBTQ+ health education for nurses: an innovative approach to improving nursing curricula. Nurse Educ Today. 2021;97:104698.

    Article 

    Google Scholar 

  • Sequeira GM, Chakraborti C, Panunti BA. Integrating Lesbian, Gay, Bisexual, and Transgender (LGBT) content into undergraduate medical school curricula: a qualitative study. Ochsner J. 2012;12(4):379–82.

    Google Scholar 

  • Obedin-Maliver J, Goldsmith ES, Stewart L, et al. Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education. JAMA. 2011;306(9):971–7.

    Article 

    Google Scholar 

  • Moll J, Vennard D, Noto R, et al. The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: where are we now? AEM Educ Train. 2021;5(2):e10580.

    Article 

    Google Scholar 

  • Parameshwaran V, Cockbain BC, Hillyard M, Price JR. Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students. J Homosex. 2017;64(3):367–81.

    Article 

    Google Scholar 

  • Nowaskie D. A national survey of U.S. psychiatry residents’ LGBT cultural competency: The importance of LGBT patient exposure and formal education. J Gay Lesbian Mental Health. 2020;24(4):375–91.

    Article 

    Google Scholar 

  • Eckstein MA, Newsome CC, Borrego ME, Burnett A, Wittstrom K, Conklin JR. A cross-sectional survey evaluating transgender-related care education in United States pharmacy school curricula. Curr Pharm Teach Learn. 2019;11(8):782–92.

    Article 

    Google Scholar 

  • Carabez R, Pellegrini M, Mankovitz A, Eliason M, Ciano M, Scott M. “Never in All My Years … ”: Nurses’ Education About LGBT Health. J Prof Nurs. 2015;31(4):323–9.

    Article 

    Google Scholar 

  • Dudar KJ, Ghaderi G, Gallant J, Dickinson J, Abourbih J, Briggs M. Queering the medical curriculum: how to design, develop, deliver and assess learning outcomes relevant to LGBT health for health care professionals. MedEdPublish. 2018;7(48):48.

    Article 

    Google Scholar 

  • Brenner N, Ross MH, McLachlan E, McKinnon R, Moulton L, Hammond JA. Physiotherapy students’ education on, exposure to, and attitudes and beliefs about providing care for LGBTQIA+ patients: a cross-sectional study in the UK. Eur J Physiother. 2022:1–9.

  • Morton RC, Ge W, Kerns L, Rasey J. Addressing Lesbian, Gay, Bisexual, Transgender, and queer health in physical therapy education. J Phys Ther Educ. 2021;35(4):307–14.

    Article 

    Google Scholar 

  • Glick JC, Leamy C, Molsberry AH, Kerfeld CI. Moving toward equitable health Care for Lesbian, gay, bisexual, transgender, and queer patients: education and training in physical therapy education. J Phys Ther Educ. 2020;34(3):192–7.

    Article 

    Google Scholar 

  • Dillman DA. Mail and telephone surveys: the total design method. Vol 19. New York: Wiley; 1978.

    Google Scholar 

  • Bidell MP. The Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS): Establishing a New Interdisciplinary Self-Assessment for Health Providers. J Homosex. 2017;64(10):1432–60.

    Article 

    Google Scholar 

  • Soled KR, Clark KD, Altman MR, et al. Changing language, changes lives: learning the lexicon of LGBTQ+ health equity. In. Vol 45: Wiley Online Library; 2022. p. 621–632.

  • Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students’ ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med. 2006;38(1):21–7.

    Google Scholar 

  • Sherman AD, Smith SK, Moore SE, et al. Nursing pre-licensure and graduate education for LGBTQ health: a systematic review. Nurs Outlook. 2023:101907.

  • Statistics Canada. A statistical portrait of Canada’s diverse LGBTQ2+ communities. 2021. https://www150.statcan.gc.ca/n1/daily-quotidien/210615/dq210615a-eng.htm.

  • Nowaskie DZ, Sewell DD. Assessing the LGBT cultural competency of dementia care providers. Alzheimers Dement (N Y). 2021;7(1):e12137.

    Google Scholar 

  • Nowaskie DZ, Patel AU. How much is needed? Patient exposure and curricular education on medical students’ LGBT cultural competency. BMC Med Educ. 2020;20(1):490.

    Article 

    Google Scholar 

  • Nowaskie DZ, Patel AU. LGBT cultural competency, patient exposure, and curricular education among student pharmacists. J Am Pharm Assoc 2003. 2021;61(4):462–469. e463.

    Article 

    Google Scholar 

  • Nowaskie DZ, Patel AU, Fang RC. A multicenter, multidisciplinary evaluation of 1701 healthcare professional students’ LGBT cultural competency: Comparisons between dental, medical, occupational therapy, pharmacy, physical therapy, physician assistant, and social work students. PLoS One. 2020;15(8):e0237670.

    Article 

    Google Scholar 

  • Chan B, Skocylas R, Safer JD. Gaps in Transgender Medicine Content Identified Among Canadian Medical School Curricula. Transgender Heal. 2016;1(1):142–50.

    Article 

    Google Scholar 

  • Jiang DD, Gallagher S, Burchill L, Berli J, Dugi D. Implementation of a pelvic floor physical therapy program for transgender women undergoing gender-affirming vaginoplasty. Obstetrics Gynecol. 2019;133(5):1003–11.

    Article 

    Google Scholar 

  • Reddy-Best KL, Reilly A, Streck K, Green D, Morris K, Doty K. Chest-Binding Practices for Trans and Nonbinary Individuals within Different Spatiotemporalities: Redefining the Meanings of Space, Place, and Time. Fashion Theory. 2023:1–28.

  • Teti M, Morris K, Bauerband L, Rolbiecki A, Young C. An exploration of apparel and well-being among transmasculine young adults. J LGBT Youth. 2020;17(1):53–69.

    Article 

    Google Scholar 

  • Casey LS, Reisner SL, Findling MG, et al. Discrimination in the United States: experiences of lesbian, gay, bisexual, transgender, and queer Americans. Health Serv Res. 2019;54:1454–66.

    Article 

    Google Scholar 

  • Rossman K, Salamanca P, Macapagal K. A qualitative study examining young adults’ experiences of disclosure and nondisclosure of LGBTQ identity to health care providers. J Homosex. 2017;64(10):1390–410.

    Article 

    Google Scholar 

  • Balsam KF, Rothblum ED, Beauchaine TP. Victimization over the life span: a comparison of lesbian, gay, bisexual, and heterosexual siblings. J Consult Clin Psychol. 2005;73(3):477.

    Article 

    Google Scholar 

  • Rubashkin N, Warnock R, Diamond-Smith N. A systematic review of person-centered care interventions to improve quality of facility-based delivery. Reprod Health. 2018;15(1):1–22.

    Article 

    Google Scholar 

  • Park M, Lee M, Jeong H, Jeong M, Go Y. Patient-and family-centered care interventions for improving the quality of health care: A review of systematic reviews. Int J Nurs Stud. 2018;87:69–83.

    Article 

    Google Scholar 

  • Obstetricians ACo, Gynecologists, Women CoHCfU. Caring for patients who have experienced trauma: ACOG Committee opinion, number 825. Obstet Gynecol. 2021;137(4):e94–9.

    Article 

    Google Scholar 

  • Xu Y, Zheng Y. Does sexual orientation precede childhood sexual abuse? Childhood gender nonconformity as a risk factor and instrumental variable analysis. Sex Abuse. 2017;29(8):786–802.

    Article 

    Google Scholar 

  • Breiding MJ, Chen J, Walters ML. The National Intimate Partner and Sexual Violence Survey (NISVS); 2010 findings on victimization by sexual orientation. 2013.

    Google Scholar 

  • Mahoney B, Davies M, Scurlock-Evans L. Victimization among female and male sexual minority status groups: evidence from the British crime survey 2007–2010. J Homosex. 2014;61(10):1435–61.

    Article 

    Google Scholar 

  • Bauer C, Miller T, Ginoza M, et al. The 2015 asexual census summary report. 2017.

    Google Scholar 

  • Messinger AM, Koon-Magnin S. Chapter 39: Sexual violence in LGBTQ communities. In: O’Donohue WT, Schewe PA, editors. Handbook of sexual assault and sexual assault prevention. Springer; 2019. p. 661–74.

    Chapter 

    Google Scholar 

  • Green BL, Saunders PA, Power E, et al. Trauma-informed medical care: CME communication training for primary care providers. Fam Med. 2015;47(1):7–14.

    Article 

    Google Scholar 

  • Raja S, Hasnain M, Hoersch M, Gove-Yin S, Rajagopalan C. Trauma informed care in medicine. Fam Community Health. 2015;38(3):216–26.

    Article 

    Google Scholar 

  • McKinnish TR, Burgess C, Sloan CA. Chapter 5: Trauma-informed care of sexual and gender minority patients. In: Gerber MR, editor. Trauma-informed healthcare approaches: a guide for primary care. Springer; 2019. p. 85–105.

    Chapter 

    Google Scholar 

  • Krempasky C, Harris M, Abern L, Grimstad F. Contraception across the transmasculine spectrum. Am J Obstet Gynecol. 2020;222(2):134–43.

    Article 

    Google Scholar 

  • Hahn M, Sheran N, Weber S, Cohan D, Obedin-Maliver J. Providing patient-centered perinatal care for transgender men and gender-diverse individuals: a collaborative multidisciplinary team approach. Obstet Gynecol. 2019;134(5):959.

    Article 

    Google Scholar 

  • Morris M, Cooper RL, Ramesh A, et al. Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Med Educ. 2019;19(1):1–13.

    Article 

    Google Scholar 

  • McCave EL, Aptaker D, Hartmann KD, Zucconi R. Promoting affirmative transgender health care practice within hospitals: an IPE standardized patient simulation for graduate health care learners. MedEdPORTAL. 2019;15:10861.

    Article 

    Google Scholar 

  • Ozkara San E, Maneval R, Gross RE, Myers P. Transgender standardized patient simulation: management of an oncological emergency. J Transcult Nurs. 2019;30(6):627–35.

    Article 

    Google Scholar 

  • Maley B, Gross R. A writing assignment to address gaps in the nursing curriculum regarding health issues of LGBT+ populations. Nurs Forum. 2019;54(2):198–204.

    Article 

    Google Scholar 

  • Yang H-C. Teaching LGBT+ health and gender education to future doctors: implementation of case-based teaching. Int J Environ Res Public Health. 2021;18(16):8429.

    Article 

    Google Scholar 

  • Minturn MS, Martinez EI, Le T, et al. Early intervention for LGBTQ health: a 10-hour curriculum for preclinical health professions students. MedEdPORTAL. 2021;17:11072.

    Article 

    Google Scholar 

  • Vance SR Jr, Deutsch MB, Rosenthal SM, Buckelew SM. Enhancing pediatric trainees’ and students’ knowledge in providing care to transgender youth. J Adolesc Health. 2017;60(4):425–30.

    Article 

    Google Scholar 

  • Vance SR Jr, Lasofsky B, Ozer E, Buckelew SM. Teaching paediatric transgender care. Clin Teach. 2018;15(3):214–20.

    Article 

    Google Scholar 

  • Grosz AM, Gutierrez D, Lui AA, Chang JJ, Cole-Kelly K, Ng H. A student-led introduction to lesbian, gay, bisexual, and transgender health for first-year medical students. Fam Med. 2017;49(1):52–6.

    Google Scholar 

  • McNiel PL, Elertson KM. Advocacy and awareness: Integrating LGBTQ health education into the prelicensure curriculum. J Nurs Educ. 2018;57(5):312–4.

    Article 

    Google Scholar 

  • Cooper MB, Chacko M, Christner J. Incorporating LGBT health in an undergraduate medical education curriculum through the construct of social determinants of health. MedEdPORTAL. 2018;14:10781.

    Article 

    Google Scholar 

  • Taylor AK, Condry H, Cahill D. Implementation of teaching on LGBT health care. Clin Teach. 2018;15(2):141–4.

    Article 

    Google Scholar 

  • Yang H-C. Education first: promoting LGBT+ friendly healthcare with a competency-based course and game-based teaching. Int J Environ Res Public Health. 2020;17(1):107.

    Article 

    Google Scholar 

  • Schweiger-Whalen L, Noe S, Lynch S, Summers L, Adams E. Converging cultures: partnering in affirmative and inclusive health care for members of the lesbian, gay, bisexual, and transgender community. J Am Psychiatr Nurses Assoc. 2019;25(6):453–66.

    Article 

    Google Scholar 

  • Kuzma EK, Graziano C, Shea E, Schaller FV Jr, Pardee M, Darling-Fisher CS. Improving lesbian, gay, bisexual, transgender, and queer/questioning health: Using a standardized patient experience to educate advanced practice nursing students. J Am Assoc Nurse Pract. 2019;31(12):714–22.

    Article 

    Google Scholar 

  • Linsenmeyer W, Stiles D, Drallmeier T, et al. advancing inclusion of transgender identities in health professional education programs: the interprofessional transgender health education day. J Allied Health. 2023;52(1):24–35.

    Google Scholar 

  • Braun HM, Ramirez D, Zahner GJ, Gillis-Buck EM, Sheriff H, Ferrone M. The LGBTQI health forum: an innovative interprofessional initiative to support curriculum reform. Med Educ Online. 2017;22(1):1306419.

    Article 

    Google Scholar 

  • van Heesewijk J, Kent A, van de Grift TC, Harleman A, Muntinga M. Transgender health content in medical education: a theory-guided systematic review of current training practices and implementation barriers & facilitators. Adv Health Sci Educ. 2022;27(3):817–46.

    Article 

    Google Scholar 

  • House of Commons Canada. The health of LGBTQIA2 communities in Canada: report of the Standing Committee on Health. Ottawa. June 2019; Available online: https://www.ourcommons.ca/Content/Committee/421/HESA/Reports/RP10574595/hesarp28/hesarp28-e.pdf. Accessed on 13 Oct 2021.

  • Murphy M. Hiding in plain sight: the production of heteronormativity in medical education. J Contemp Ethnogr. 2016;45(3):256–89.

    Article 

    Google Scholar 

  • Spurlin WJ. Queer theory and biomedical practice: The biomedicalization of sexuality/the cultural politics of biomedicine. In: Queer Interventions in Biomedicine and Public Health. Springer; 2023. p. 7–20.

  • Malatino H. Trans care. U of Minnesota Press; 2020.

  • Jacobson R, Joel D. An exploration of the relations between self-reported gender identity and sexual orientation in an online sample of cisgender individuals. Arch Sex Behav. 2018;47:2407–26.

    Article 

    Google Scholar 

  • Marsh P, Polster R, Ricco G, Kemery SA. Factors influencing faculty decisions to teach LGBTQ content in undergraduate nursing programs. Nurs Educ Perspect. 2022;43(4):228–32.

    Article 

    Google Scholar 

  • Sherman AD, Klepper M, Claxton A, et al. Development and psychometric properties of the tool for assessing LGBTQI+ health training (TALHT) in pre-licensure nursing curricula. Nurse Educ Today. 2022;110:105255.

    Article 

    Google Scholar 

  • Rew L, Becker H, Tang M, Liu Y, Wang Y, Croce E. Sensitivity Toward Gender and Sexually Diverse Populations: Development of a Scale. J Nurs Educ. 2022;61(7):383–9.

    Article 

    Google Scholar 

  • Bethlehem J. Selection bias in web surveys. Int Stat Rev. 2010;78(2):161–88.

    Article 

    Google Scholar 

  • Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2013;47(4):2025–47.

    Article 

    Google Scholar