Quiet Gaps, Loud Impact: The Reality of LGBTQ+ Inclusion in GME

Medicine prides itself on its commitment to evidence, equity, and excellence — yet for LGBTQ+ patients and providers, a quiet contradiction persists. While academic medicine has embraced broader diversity initiatives, it continues to fall short in one vital area: LGBTQ+ health education. Behind the white coats and mission statements and policy implementations, a silent curriculum teaches future physicians that queer identities are peripheral, optional, or invisible. This omission doesn’t just affect comfort or culture, it impacts care.

As medical educators, residency leaders, and healthcare professionals, we must ask: What message do we send when over half of medical schools provide no LGBTQ+ training at all? What systems are we reinforcing when LGBTQ+ applicants feel compelled to hide their identities during interviews? And what cost are we willing to accept as mistreatment and burnout continue to disproportionately affect LGBTQ+ trainees?

This blog, developed by Germane Solutions’ LGBTQ+-focused Employee Resource Group, explores the visibility gaps that persist in LGBTQ+ medical education, from recruitment disparities to specialty-specific discrimination. Creating inclusive medicine isn’t just about representation, it’s about rethinking the foundation of how we train, support, and retain every physician.

Visibility and Gaps in LGBTQ+ Medical Education

Efforts to promote diversity in academic medicine have increased, but LGBTQ+ health competency is still not a standard across medical education. A survey of 138 academic institutions found that only 16% offer comprehensive LGBTQ+ training, 32% offer some training, and over half provide none at all (Khalili). Without formal education in LGBTQ+ healthcare, many physicians feel unprepared to provide gender-affirming or identity-sensitive care (Juarez).

This lack of training has real consequences for patients and providers. In a qualitative study, many healthcare professionals reported uncertainty and discomfort when treating gender-diverse patients, citing a lack of training and exposure (Sileo). Furthermore, while there is increased focus on racial and gender equity, education around sexual and gender minorities continues to lag behind (Danckers).

Recruitment Challenges for LGBTQ+ Applicants

Discrimination and Burnout

Specialty-Specific Experiences in GME

Looking Ahead: Building the Future of Inclusive Medicine

The disparities reflect more than a curriculum gap. They represent a structural failure to see LGBTQ+ physicians and patients as essential to the fabric of healthcare. As the next generation of doctors enters the field, they deserve more than reactive policies or surface-level diversity statements. They deserve an education that sees their full selves and prepares them to care for others with that same depth and dignity.

Improving LGBTQ+ inclusion in medical education is not just a moral imperative, it's a professional one. Institutions that fail to invest in gender-affirming care, inclusive training, and safe learning environments risk losing both talent and trust. But those willing to confront the data, examine specialty-specific cultures, and implement meaningful reform have the chance to lead a transformation that benefits everyone in medicine.

Looking ahead, the charge is clear: close the gaps, increase visibility, and center the lived experiences of LGBTQ+ physicians. In doing so, we move closer to a healthcare system where no provider has to choose between their identity and their career and no patient is treated as invisible.

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Works Cited

Danckers, Mauricio, Jake Nusynowitz, Lily Jamneshan, et al. “The Sexual and Gender Minority (LGBTQ+) Medical Trainee: The Journey Through Medical Education.” BMC Med Educ, vol. 24, no. 67, 2024, The sexual and gender minority (LGBTQ+) medical trainee: the journey through medical education | BMC Medical Education | Full Text

Kumaran, Yogesh, Jaime Bellamy, Ryann Maciejewski, Kirsten Tulchin-Francis, Julie Balch Samora. “How Much Bullying and Discrimination Are Reported by Sexual and Gender Minorities in Orthopaedics?” Clinical Orthopedics and Related Research, vol. 482, no. 8, 2024, How Much Bullying and Discrimination Are Reported by Sexual and Gender Minorities in Orthopaedics? - PubMed.

Heiderscheit Evan A., BS, Cary Jo R. Schlick, MD, MS, Ryan Ellis, MD, MS, et al. “Experiences of LGBTQ+ Residents in US General Surgery Training Programs.” JAMA Surg, vol. 157, no. 1, 2022, Experiences of LGBTQ+ Residents in US General Surgery Training Programs | Medical Education and Training | JAMA Surgery | JAMA Network.

Sileo, Katelyn M., Aleta Baldwin, Tina Anh Huynh, Allison Olfers, C. Junda Woo, Sean Greene, Gregory Casillas, Barbara Taylor. “Assessing LGBTQ+ Stigma Among Healthcare Professionals: An Application Of The Health Stigma And Discrimination Framework In A Qualitative, Community-Based Participatory Research Study.” The Journal of Health Psychology, vol. 27, no. 9, 2022, Assessing LGBTQ+ stigma among healthcare professionals: An application of the Health Stigma and Discrimination Framework in a qualitative, community-based participatory research study - PMC.

Khalili, Joshua. “LGBT-Competent Physicians Are Scarce At U.S. Academic Medical Practices, UCLA Study Finds.” UCLA Health, 2015, LGBT-competent physicians are scarce at U.S. academic medical practices, UCLA study finds | UCLA Health.

Juarez, Paul D., Aramandla Ramesh, Jayne S. Reuben, Asa E. Radix, Cheryl L. Holder, Katherine Y. Brown, Mohammad Tabatabai, Patricia Matthews-Juarez. “Transforming Medical Education to Provide Gender-Affirming Care for Transgender and Gender-Diverse Patients: A Policy Brief.” The Annals of Family Medicine, vol. 21, suppl.2, 2023, Transforming Medical Education to Provide Gender-Affirming Care for Transgender and Gender-Diverse Patients: A Policy Brief | Annals of Family Medicine.

Grova, Monica M., MD, MST, Sean J. Donohue, BA, Matthew Bahnson, MA, Michael O. Meyers, MD, Edward M. Bahnson, PhD. “Allyship in Surgical Residents: Evidence for LGBTQ Competency Training in Surgical Education.” Education and Career Development, vol. 260, 2021, Allyship in Surgical Residents: Evidence for LGBTQ Competency Training in Surgical Education - Journal of Surgical Research.