What Do LGBTQ+ Medical Students Experience and Need in Medical School? A Multicenter Qualitative Study in Thailand.

Purpose: This study evaluated the experiences and needs of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minorities (LGBTQ+) attending medical schools in Thailand.

Method: Medical students from 4 medical schools in Thailand were recruited in 2022. LGBTQ+ participants were selected via purposive sampling and invited for semistructured interviews. Verbatim transcripts were analyzed using reflexive thematic analysis.

Results: Interviews were conducted with 39 students identifying as lesbian, gay, bisexual, transgender, queer, questioning, nonbinary, asexual, or androgynous, with a mean age of 21. The experiences of these LGBTQ+ individuals in medical school had 4 themes: (1) normalization of LGBTQ+ identity among friends, or not openly identifying as LGBTQ+ (because it was viewed as unnecessary), facilitated everyday life; (2) fear of negative judgments from being LGBTQ+ by attending physicians and patients; (3) authenticity to sexual or gender identity provided relief; and (4) personal histories of discrimination affected self-disclosure and social dynamics. Overall, approximately 17% of reported stressors were directly associated with participants' LGBTQ+ identity. The identified needs within medical schools comprised 2 themes: (1) treat each other with equal respect (with 3 subthemes: nonjudgmental attitudes supported by effective discrimination reporting systems; more LGBTQ+-related education and extracurricular activities; and activities driven by voluntariness without gender-based selection); and (2) abolishment or amendment of regulations that strictly enforce gender binaries. These amendments could include implementing flexible dress codes, establishing gender-neutral restrooms and dormitories, and introducing gender-neutral titles. Transgendered participants reported experiencing the most significant disparities due to binary regulations and infrastructures.

Conclusions: LGBTQ+ medical students in Thailand reported fear of negative perceptions by attending physicians and patients. Exposing everyone, particularly attending physicians, to examples of unintentional discrimination is recommended. There is also a need to promote LGBTQ+-related education and extracurricular activities and to ensure activities and regulations are not gender-divided.