Back to Front PageVOLUME 6, NUMBER 4

Opening Medical Schools' Doors for Gay and Lesbian Students

By Jennifer Proctor

"Homosexual medical students are often unwilling to reveal their orientation because of possible social stigmatization and discrimination. Feeling alone, they may find the medical school experience extremely discom-forting. Such students are in need of support, socializing, and friendship." So says a 1991 study published in Academic Medicine.

A decade later medical schools are taking steps both large and small to encourage tolerance of diverse sexual orientations and make gay and lesbian students feel more welcome. Some steps can be as simple as putting a sticker on your door, says S. Scott Obenshain, M.D., associate dean of undergraduate medical education at the University of New Mexico (UNM) School of Medicine.

Dr. Obenshain prominently displays two stickers in his office - a rainbow, which is a symbol of support for gays and lesbians, and one that comes from Parents and Friends of Lesbians and Gays (P-FLAG), a national association dedicated to the health and well-being of gay, lesbian, bisexual, and transgendered people as well as their families and friends.

"The rainbow on the door lets students know that we are gay friendly, that we understand the issues that face lesbian, gay, bisexual, and transgendered students, and even that we may be dealing with these issues in our own lives," Dr. Obenshain says. Gay and lesbian students often assume indifference or even hostility on the part of administrators unless school officials make it known otherwise, he says.

But Dr. Obenshain doesn't restrict the school's efforts to a sticker. Students at the UNM School of Medicine are required to take the biweekly course "Perspectives in Medicine," which includes special training sessions focusing on sexual identity and sexual awareness. Additionally, for more than 15 years, the school's human sexuality course has included a session with a panel of gay, lesbian, bisexual, and transgendered individuals, sometimes including medical students and faculty.

The panel, Dr. Obenshain says, is a useful exercise for students who may be uncomfortable with homosexuality. "It's easier to label a group as 'bad'; it's harder when you actually get to know people, including students and faculty, as individuals. Knowing gay people one-on-one can change students' worldviews." Dr. Obenshain adds that an important element in creating an environment of tolerance is diversity training for faculty as well as students.

But despite an administration's best efforts, discriminatory incidents can happen. Several years ago, a few homosexual students at the UNM School of Medicine received hate mail centering on their sexual orientation. Dr. Obenshain says the only way to handle such acts of discrimination is swiftly and unequivocally. "I think the students felt better knowing that the dean acted immediately, calling this unacceptable behavior." He urges administrators to speak out and let their medical center community know there will be zero tolerance for jokes and put-downs based on sexual orientation.

Dr. Obenshain stresses that medical schools need to go the extra mile to make gay and lesbian students feel at ease given society's remaining prejudices and sometimes homophobic undercurrents. "We are facing an uphill battle to reach out to lesbian, gay, bisexual, and transgendered medical students because of how things are culturally in our society. Medical school is not always perceived as a safe environment," says Dr. Obenshain, who also works to make the Albuquerque community more accepting of those with diverse sexual orientations.

Respecting Diversity The state of Vermont has a history of tolerance for diverse sexual orientations, and the University of Vermont (UVM) is no exception, says Marga Sproul, M.D., associate dean for student affairs at UVM's College of Medicine. "We work to create a respectful and open environment that encourages a diverse student body."

The school has built a foundation for this environment. At orientation, Dr. Sproul reads a faculty statement about respect for diversity and courage to challenge intolerance. It reads, in part: We affirm our commitment to creating and maintaining a community which supports and encourages respect for every individual. The faculty of the College of Medicine deplores actions that intimidate, humiliate, or demean any person or group. We particularly condemn actions manifesting attitudes of racism, sexism, or intolerance based on religious belief, ethnic origin, sexual orientation, age, veteran status, or disability.

Students who violate the statement's principles can face disciplinary language and action. In addition, medical students' advancement is based not only on grades but also on personal and professional qualities, creating a mechanism to encourage professional fitness and to punish behavior not deemed fit for a career in medicine, Dr. Sproul says.

The statement is just one of the college's efforts to make gay and lesbian students feel they can find validation and support at the medical school, she says. Like UNM's Dr. Obenshain, Dr. Sproul and other administrators at the college prominently display in their offices pink triangle and rainbow "ally" stickers.

Dr. Sproul also meets with every first-year student and asks about the student's individual support systems, including whether or not he or she has a "partner." She uses the gender-neutral word to indicate that the environment is safe and students can be as open as they choose to be. "As with any students, it's important to be an active listener and be available by phone, e-mail, and in person for those with diverse sexual orientations," Dr. Sproul says.

UVM also uses its curriculum to foster a welcoming, diverse environment. First-year medical students take the class "Physician and Society," which includes a session on homosexuality and the impact of being gay or lesbian. Dr. Sproul says oftentimes students and faculty volunteer information about themselves, and it helps others to know the school has an active gay, lesbian, bisexual, and transgendered community.

At UVM, there is also an informal gay and lesbian medical student organization. Organizers send an informational e-mail to every first-year student at the beginning of the year. "I put much of the responsibility for these types of activities on the medical students themselves, who need to work continuously to create an environment that supports diversity, including diversity of age, gender, ethnicity, and sexual preference," Dr. Sproul says.

She adds that gay, lesbian, bisexual, and transgendered students feel confident they will be respected at the school because of "word of mouth" from peers. "It's the best way, and it works. New students hear it from students who have been here awhile, and it carries the greatest authenticity."

Translating Standards Into Practice In October 2000, the Liaison Committee on Medical Education (LCME) adopted a standard stating, "In the admissions process and throughout medical school, there must be no discrimination on the basis of gender, sexual orientation, age, race, creed, or national origin."

The Lesbian, Gay, Bisexual, and Transgender (LGBT) Caucus of the American Medical Association Medical Student Section pressed the LCME to pass this standard. Peter Chien, a student at the New York University School of Medicine, chairs the AMA's LGBT Caucus. He says a stated diversity policy is a good first step for medical schools searching for ways to be more open and friendly toward students with diverse sexual orientations. Chien is also the student representative on the Gay and Lesbian Medical Association (GLMA) board of directors.

At NYU, the LGBT medical students have a chapter under the American Medical Student Association (AMSA) called Lesbian, Gay, and Bisexual People in Medicine (LGBPM). The chapter sponsors events funded by the school's student council with support from the dean's office. Chien adds that it is helpful to have visible support straight from the dean's office. "Institutional support really goes a long way," he says. Gay- and lesbian-identified faculty who can serve as role models and mentors are also important in creating a welcoming environment, Chien says.

Gay and lesbian students do consider the environment when applying to medical schools. Chien says when he was applying, he would examine admissions packets and look for nondiscrimination policy statements that included sexual orientation. When he visited medical schools, he would check to see if they had a gay and lesbian club. "First, I considered all the best schools that I really wanted to get into; from that pool, I looked at the policies and environment for gay and lesbian students," Chien says.

The Medical College of Ohio (MCO), for one, boasts an award-winning Gay and Straight Alliance. The club, which seeks to "illuminate the presence of gays and lesbians on campus," tackles such issues as institutional inclusiveness, gay and lesbian physician and student challenges, and the experiences of lesbian, gay, bisexual, and transgendered individuals in the health care system. The club networks with national and community groups, and serves as a professional and social network for students and physicians of all sexual orientations.

MCO's Gay and Straight Alliance won the second-runner-up title at the AMSA Gay/Lesbian Award competition and was recognized last March. Recent activities of the club include a panel discussion for World AIDS Day and a lesbian/bisexual breast cancer awareness video and panel discussion.

The club receives student fees to support its programs just as any other club does at the college, says Patricia Metting, Ph.D., assistant provost and associate dean for student services. She credits the efforts of the alliance's co-presidents with MCO's recent offering of domestic partner benefits as part of the school's student health insurance.

But while clubs, policies, and curricula are all key elements in fostering tolerance for gay and lesbian students, medical school administrators must lead by example, all experts stress. Vermont's Dr. Sproul says medical school faculty and deans' treatment of students acts as a model for how students, as doctors, will treat their patients. "What we do is infinitely more important than what we say," she stresses. "We all need to behave in a way that demonstrates acceptance, trust, and welcoming attitudes."

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08 February 2005