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December 7, 2011

Lesbian, Gay, Bisexual, and Transgender Health and Medical Education—Reply

JAMA. 2011;306(21):2326-2327. doi:10.1001/jama.2011.1783

In Reply: Augmenting the currently limited LGBT health–related medical education, as Dr Ng suggests, requires fostering a safe environment to promote faculty development, developing inclusive and efficacious curricular and practice models, and emphasizing the importance of all clinicians delivering competent LGBT patient care.

Ng states that current history taking is superficial and fails to gather in-depth information needed to provide excellent patient care. We agree and reported in our study that topics related to LGBT primary care (eg, chronic disease risk) and transgender-specific care (eg, transitioning) were among the least taught. Deans acknowledged dissatisfaction, with approximately 70% describing their institution's LGBT-related content as “fair” or worse. Comprehensive history taking involves understanding patient identities, beliefs, and behaviors and appreciating the influence that each contributes to health and well-being. When students learn how to ask these advanced questions, they can learn to better understand their patients' lives and improve patient care for all patients, not only LGBT patients.