Moving medical education forward to support our changing communities

I remember the moment I decided to come out.

For me it was one of those things that built up and up until finally it needed to happen. I remember, I was driving home with my mum and talking about what car I should get, I said I quite like the Mini Cooper, a car I think is perceived by an older generation to be a girl’s car.

My mum quipped, “are you gay?”

Quietly, I replied “yes”.

There was silence in the car as she realised what had happened.

That was that, the weight on my shoulders was lifted.

In retrospect telling my mum something like that while she was driving was not the best of ideas, but I needed to seize the opportunity. I have been incredibly fortunate that I have never faced discrimination or bullying because of my sexuality. I know from the experience of my friends that bullying someone because of who they love is still rife in schools and sadly in some universities.

In fact, one of my classmates was forced to endure conversion therapy, his parents being devout Catholics, after months of apparent success the therapy ended. He forced himself into relationships with women and took several years to come to terms to what had happened to him. He came out again to his parents and after months of denial they came to terms with his sexuality and accepted him.

I was shocked to find practices like this still existed in the UK and highlights the need for more education on LGBTQ+ issues.

My secondary school was a Catholic grammar which towed the church line on many issues including abortion and LGBTQ+ relationships. Ultimately the students didn’t take much of our catholic teaching onboard but many of my gay friends from school have had to educate themselves. Sexual health education was always themed around don’t have sex, abortion teaching was themed around not having sex and even in science classes we were told to not have sex.

The conservative nature of this sexual education means so many of the students don’t have the knowledge of how to access contraception or testing facilities. Sex and sexuality become taboo with this conservative approach and perhaps it’s time for a change. We need radical reform of sexual education in the UK so students are equipped to know what they might experience during puberty, how they might start to define or redefine their sexuality and how they come to terms with their own gender identity.

Now that I’m approaching the end of my time in medical school, I have had the chance to reflect on my teaching. There have been some interactive classes on gender identity and LGBTQ+ issues in wider society but there remains a gap in our teaching for LGBTQ+ healthcare. I understand studying medicine is a lifelong journey of learning and changing practice but there is no reason why medical schools can’t teach about LGBTQ+ health at an early stage.

In fact, in a 4-week GP placement I came across 3 patients with LGBTQ+ related health concerns and without the knowledge base I was not confident in dealing with this. Society is constantly changing and education at all levels struggles to adapt quickly enough.

Even now with the Black Lives Matter movement medical schools have not answered the calls to include healthcare issues faced by minority groups. Dermatology is a specialty that is most often spoken about. We are shown pictures of malignancy, acne and pruritus in white skin, but never in any other. It is time for medical schools across the United Kingdom to come to terms with the need to educate tomorrow’s doctors about more than just the healthcare issues faced by white straight cis-gendered people.

To continue teaching in this way will only propagate worse healthcare outcomes for LGBTQ+ and BAME members of society.

On a final note, although we are still in varying degrees of lockdown across the UK it is worth sparing a moment to celebrate those in your life who make you proud for being who they are.

Celebrate your brother or sister, mum or dad, friends or neighbours.

Let them know that they are loved, and what’s wrong with a little positivity once in a while?

Matthew Murtagh is co-chair of the BMA’s Scottish Medical Students Committee

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