22nd June 2018, Volume 131 Number 1477

Oscar Taylor, Charlene M Rapsey, Gareth J Treharne

People with marginalised sexual and gender identities face many health inequities across diverse areas, including cancer,1,2 addiction and mental health difficulties,3,4 domestic violence5 and sexual health.4,6 Research indicates negative healthcare…

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Negative healthcare experiences are common for people with diverse sexual and gender identities. A survey was distributed to staff responsible for curriculum in the pre-clinical years of New Zealand’s medical schools, inquiring about the sexuality and gender content they teach, and their perceived attitudes around this content. Results showed that LGBTQI-specific content is covered minimally and some staff are aware of a gap in teaching content. The staff felt this content would be easy to teach, but finding the time to include it was difficult. Experience with sexuality and gender in a healthcare setting and further faculty support could potentially help with providing the opportunity to facilitate the sensitive inclusion of sexuality and gender content in the medical school curriculum.



To investigate inclusion of sexuality and gender identity content, attitudes and barriers to inclusion of content in preclinical curricula of New Zealand medical schools from the perspective of key teaching staff.


Staff responsible for curriculum oversight at New Zealand’s two medical schools were invited to complete a mixed-methods survey about sexuality and gender identity content in their modules.


Of 24 respondents, the majority included very little content relating to sexuality or gender identity (33%) or none at all (54%). This content was deemed important by most participants (69%), and none believed there should be less such content in their curriculum. Time was reported to be the main barrier limiting inclusion of such content.


Our finding of limited content is consistent with international literature. Our findings extend the literature by revealing that barriers to greater inclusion of content are not due to overt negative attitudes. Staff responsible for preclinical medical curriculum oversight have positive attitudes about content relating to sexuality and gender identity but perceive curriculum space to be a limiting barrier. This is important as it informs approaches to change. Future interventions with medical schools should focus on methods to increase diverse content as part of existing teaching, education to increase knowledge of LGBTQI relevant material and potentially incorporate strategies used to address unconscious bias. Addressing the perceived barriers of time constraints and lack of relevance is required to ensure medical students receive training to develop the competencies to provide positive healthcare experiences for all patients regardless of sexuality and gender identity.

Author Information

Oscar Taylor, Post-Graduate Clinical Psychology Student, Department of Psychological Medicine, Dunedin School of Medicine; Department of Psychology, University of Otago, Dunedin;
Charlene M Rapsey, Lecturer, Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin; Gareth J Treharne, Senior Lecturer, Department of Psychology, University of Otago, Dunedin.


Dr Charlene M Rapsey, Department of Psychological Medicine, University of Otago, 464 Cumberland Street, Dunedin 9054.

Correspondence Email


Competing Interests



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