Preparing For LGBTQ Health Issues as an SP Educator
By: Kris Slawinski, The University of Chicago Pritzker School of Medicine

Carrie Bonhert blazes our path to providing LGBTQ healthcare simulations with her ongoing work and presentations at ASPE and other medical education conferences.

In 2012 the AAMC convened the Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development. The committee’s goal was to identify the disparities in healthcare of the nation’s LGBT population, and to develop medical care competencies and strategies for implementation in UME.

The committee’s findings are eye-opening. A few examples include the following facts:  41% of transgender people have attempted suicide; all LGBT folk are at an increased risk for depression, suicide and substance disorders; and most have suffered physical violence, humiliation or harassment at school, home and work. After experiencing hostility from healthcare providers and staff who are unprepared to serve, or openly discriminate against, this population, a large number no longer seek medical care.

As SP educators, we can expect our institutions to ask us to design and implement patient encounters involving everything from practice at asking personal pronouns, to establishing care for a new patient who wishes to transition. Some of us already have some experience addressing this patient population, but others are at a huge disadvantage. Don’t know what “DSD” means? How about “natal sex,” “cisgender,” “gender identity,” “gender nonconforming,” and “gender queer”?

That was me over a year ago, but then I attended Carrie Bonhert’s presentation at ASPE 2016 titled “Are You Ready for the AAMC LGBT-DSD Guidelines? Part I.” Bonhert, MPA, CHSE, is a Simulation Educator at the University of Louisville School of Medicine, as well as VP for Operations for ASPE and a recipient of ASPE’s Outstanding Emerging Leader Award. The University of Louisville was asked to be the pilot site for the AAMC’s medical education guidelines, and when Bohnert’s dean approached her to discuss it, her response was, “I’m not doing a gay OSCE,” as she feared such a singular focus could result in stereotyping of this population. Reassured that that wasn’t the agenda, she began to survey the local LGBTQ community about their healthcare experiences, needs and preferences, and worked with a team to develop a curriculum according to their responses. The result was 50.5 curricular hours of LGBTQ content added to basic science and clinical skills courses, with the potential to serve as a model for other schools.

Bonhert, decidedly dedicated to addressing social justice issues through the use of SP-based simulation, has become a passionate advocate for LGBTQ healthcare equity, which becomes apparent as she empathically discusses “micro-aggressions” and “triggers” in recruitment of LGBTQ SPs, along with other issues. After attending her workshop in 2016, and with my head still spinning, I took a SafeSpace workshop on my home campus. I idealistically affixed SafeSpace stickers on entrances to our CPC and SP breakroom afterward, not realizing for perhaps six months that most of our SPs possibly did not have a clue what it meant! So, to prepare our SPs and raise their awareness of transgender students, SPs, and issues in general, we initiated a required 2.5 hour paid SP in-service on the topic of SafeSpace, with the first iteration coming up in a few weeks. I myself was able to implement what I had learned almost immediately, when a friend announced his transition to “her/she.” I was able to offer my support while admitting that I would need her help to know what that might entail.

Our local Chicago Simulation Consortium invited Bonhert to present on trans health simulation at our annual one day conference this past August, and the response was overwhelmingly positive. We can all look forward to Bonhert’s latest workshop at ASPE 2018, and in the meantime access resource links below for further information on this critical topic:

The University of Louisville School of Medicine to Begin Pilot Program for LGBTQ Health

Sexual and Gender Minority Health Resources

Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born with DSD

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