Dr Hartland (they/he) is a Lecturer and the Deputy Education Director for Student EDI at Bristol Medical School. Jo left medicine in 2018 to work at the University of Bristol Medical School. Their role at the school focuses on teaching students to examine the bias and privilege they bring to clinical practice, as well as ensuring that the voices of marginalised communities are centred in curriculum development. Outside of their university work they sit on the Medical Schools Council Executive Board for the EDI Alliance, and as a queer activist they are the lead author of the GLADD “UK Medical School Charter on So-called LGBTQ+ Conversion Therapy”. They have a special interest in representations of queerness in medicine, both in curricula and in ideas of professional practice.
My vison for LGBTQIA+ health care teaching in medical curricula is…joy.
If you were to say that is a simplistic answer then you would be right, but that doesn’t mean it’s a bad one. The truth is I could have chosen any number of goals, because LGBTQIA+ teaching in all healthcare curricula remains poor.
It is true that we desperately need better education on trans healthcare to help tackle the current demonization of the trans community in the UK. Creating doctors of the future who are informed about these treatment options may also ease the burden on gender identity clinics, promoting models of shared care that could reduce the unjust waiting times for appointments.
My own work with the Association of LGBTQ+ Doctors and Dentists (GLADD) has made it abundantly clear to me we must do far more to teach about the dangers of so-called LGBTQIA+ conversion therapy. Supporting a ban that is inclusive of both gender identity and forms of religious ‘conversion therapy’ is one of the most important ways we can protect our patients from this abuse.
As the field of HIV treatment and prevention continues to evolve our curriculums must stay up-to-date, with graduates able to clearly discuss PrEP, challenge stigma and understand that undetectable means untransmissible.
Mental health is a hugely complex issue, made only greater by the loneliness experienced by some LGBTQIA+ people during the pandemic. Not only do we need to do more to tackle this, but we need our graduates to understand the burden of minority stress. It is not being part of the LGBTQIA+ community that causes the disproportionate experience of poor mental health, but it is living in a society and receiving healthcare that is so deeply rooted in cisgenderism and heteronormativity.
We also urgently need to change the use of harmful stereotypes in our teaching, especially as old models of hate are reused in the media around issues like monkey pox and the gender critical movement, framing LGBTQIA+ people as diseased, dangerous and in need of fixing. These narratives are designed to invalidate our experiences and paint us as the cause of our own ill health.
These are all hugely important issues, but ultimately where would I like to see LGBTQIA+ healthcare teaching in the future? What is my vision?
Medicine doesn’t have to be reactive, it doesn’t have to stereotype, and it doesn’t have to placate hate. Instead we can aim to create curricula that celebrate LGBTQIA+ communities, tackling these same issues through a different and more positive lens.
My vision is for us to reach a place where LGBTQIA+ health doesn’t have to be defined by trauma, but instead by joy. Gender dysphoria is a terrible thing to experience, but what about gender euphoria? What about recognising all the ways queer love and queer families exist? What if we focused on teaching the positive possibilities, the life changing outcomes, of truly inclusive and affirming healthcare?
What if we helped our healthcare staff understand that this isn’t just about creating a future for LGBTQIA+ people free of inequality. It’s about creating a future where LGBTQIA+ people can flourish.
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