Q: How did you first get involved in LGBTQ+ care?
A: My journey into the world of LGBTQ+ healthcare is rooted in my personal experiences navigating the health system as a queer woman. It came to a head when I was in medical school studying for an infectious disease module. I noticed that any time a practice question stem mentioned a gay man, the answer was always related to the sequelae of HIV. Gay men, according to these practice questions, had no other illnesses, and no one other than gay men would be diagnosed with HIV; it was a one-dimensional, narrow-minded approach that was training me to anchor on principles based on stereotypes and not epidemiology. During this study period, I also happened to have a doctor’s appointment in which I was met with derision—not for the first time—when answering questions related to my sexual health because my doctor was making assumptions about my sexuality as well as plans for childbearing. It reinforced to me that the only way in which health professionals are trained about queer people is that “gay man = HIV,” when LGBTQ+ health is obviously so much more than that. (I talk about this more in an article I wrote for SheMD here. At that time, my thought was that if I made a curriculum to teach core concepts in queer health that would be mandatory for medical students at my school, then a new generation of doctors would be equipped with the knowledge, familiarity, and skillsets needed to provide competent care. That was what led me to develop a series of online modules using primary literature as well as case-based scenarios, which I called the “Queericulum.”.
Q: You co-authored Teaching LGBTQ+ Health, a free online curriculum designed for educators teaching LGBTQ+ health. How did this project get started, and what was your goal for the curriculum?
A: As I continued throughout medical school and started connecting with LGBTQ+ health leaders across the country, I came to understand that a lot of medical education projects working to advance queer health are driven by motivated students and that a key problem with such curricula is whether they can be sustained once the pioneers of the projects graduate. I also realized that my idealism of focusing on undergraduate medical education as the target audience of such projects also meant that it would take years, if not decades, for queer health literacy to become the norm among health professionals. That was when I realized that faculty development posed a unique intervention opportunity, which led me to partner with colleagues at Stanford to develop Teaching LGBTQ+ Health. The aim was that we would not only deliver queer health content but also strategies for educators as to how to teach it longitudinally to their learners.
Q: In 2022, you co-authored two publications related to LGBTQ+ health. In one of these studies, Evaluating Medical Students’ Views of the Complexity of Sexual Minority Patients and Implications for Care, you determined that students view LGB patients as more complex compared with heterosexual patients. How does this finding impact care for LGB patients, and what does this indicate for physician education on LGB care?
A: Our findings pointed not only to the need for improved education in LGBTQ+ health content but also to the need for increased familiarity and exposure to sexual and gender minority (SGM) identities in healthcare. The results of our study affirmed what I had sensed when my journey into queer health began: that when current education efforts reinforce that the only notable queer identity is a gay man and the only ailment he could have is HIV, anything outside of this paradigm would be unfamiliar and decrease one’s confidence in evaluation and treatment of the patient. There is an urgent need for physicians to improve our competence and confidence in queer health in order to provide high-quality care to a population that already experiences health disparities and victimization. Paper linked here.
Q: Do you have any current projects or research you are working on related to LGBTQ+ care?
A: Currently, I am working with my colleagues with whom I developed the Teaching LGBTQ+ Health course to analyze its efficacy and impact. It was illuminating to read the reflections our participants shared as they worked through the material.
Q: How can SGIM members support your work?
A: I encourage SGIM members to check out the Teaching LGBTQ+ Health course and to share widely! I am always happy to collaborate with individuals interested in improving queer health education across undergraduate and graduate medical education as well as faculty development/continuing education spectrum—do not hesitate to reach out to me at shana.zucker at jhsmiami.org.
Job Position & Institution
PGY-2 Internal Medicine Resident at the University of Miami/Jackson Memorial Hospital