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Many members of the Rainbow/Takatāpui community feel uncomfortable and discriminated against when engaging with the healthcare system.

There needs to be better understanding of the community’s diverse needs and experiences, say two major health sector organisations.

The New Zealand Medical Students’ Association and the NZ Medical Association want comprehensive and accessible training to be a core competency for all medical staff, educators, and students to help improve the workforce and serve Rainbow/Takatāpui patients.

“NZMSA, NZMA and other partners are dedicated to working towards an Aotearoa where our LGBTQIA+ whānau feel safe and respected in the health setting. This hinges on proper training and education of health professional staff within medical school and in clinical settings,” the two organisations say in a joint statement issued today.

Anu Kaw, NZMSA President, says the lack of formal teaching by the Universities around LGBTQIA+Takatāpui patients is alarming and impacts both quality of care and education.

“Medical students are apprentices. Our learning filters down from teachers, house officers, registrars and consultants.

“Though there is a growing awareness of the health and social inequities faced by our Rainbow community, there is persisting discrimination within our healthcare service.

“We are calling for meaningful change to advocate for our Rainbow whānau.”

Rainbow community member and medical student Indira Fernando says students have experienced medical staff trivialising or disparaging Rainbow patients in private, and staff members often seem confused about how to treat Rainbow patients.

“It is very common for members of the community to be in rooms where people have been speaking about us as if we are hypothetical or a debate topic.

“Educators teaching us about LGBTQIA+ health frequently express that they ‘don’t understand’ the material they are teaching. This puts Rainbow and Takatāpui students in a difficult position where we feel obligated to ‘out ourselves’ and teach our peers about our experiences and community.

“This is very unsafe and unfair to everyone. Members of marginalised groups should never be pressured to educate about their communities, especially when they themselves are supposed to be learning.

“We often feel that we cannot bring up these situations with other staff because we don’t want staff members to get in trouble. We recognise that the real issue is not the staff members themselves but the lack of educational support they receive in this area.

 “While there will always be people who treat our community poorly out of hatred and intolerance, there is no place for this in medicine and I really hope that by educating everyone else we can make medicine safer for all patients, staff and students.”

NZMA Chair Dr Alistair Humphrey said there are no excuses for discrimination or unequal treatment of any member of the Rainbow/Takatāpui community.

“Treating all students and patients with dignity, respect and fairness is cornerstone to a modern healthcare system,” he says.

“There have been local initiatives to teach doctors and other healthcare professionals about issues facing Rainbow/Takatāpui patients and how to most appropriately engage with this sector of the community. This is very much in line with the NZ Medical Council’s statement on Cultural Safety.

“Engaging with patients in a culturally safe way is a requirement of all doctors.  It involves doctors acknowledging and addressing any of their own biases, attitudes, assumptions, stereotypes, prejudices, structures and characteristics that may affect the quality of care provided.  

“Cultural safety training is a requirement throughout a doctor’s career, is not restricted to indigenous status or ethnicity, but also includes age/generation, gender, sexual orientation, socioeconomic status, religious and spiritual beliefs.  Accordingly, such training should also encompass teaching about and from members of the Rainbow/Takatāpui community and the local initiatives in this area should be rolled out across the profession.”

The statement in full:

The Rainbow and Takatāpui communities of Aotearoa still face significant inequities, especially in the area of healthcare. Studies show that rainbow youth are four times as likely to experience significant depressive symptoms. Poor training and education of Medical Professionals contributes towards the community experiencing overall lower health access and poorer outcomes especially within key services such as mental health care. The Counting Ourselves survey reported over a third of its participants had avoided accessing healthcare out of fear of being disrespected or demeaned.

NZMSA, NZMA and other partners are dedicated to working towards an Aotearoa where our LGBTQIA+ whānau feel safe and respected in the health setting. This hinges on proper training and education of Health Professional Staff within medical school and in clinical settings.

We call for comprehensive and accessible training as a core competency for all medical staff, educators and students working in Aotearoa to help improve our workforce and serve our Rainbow Patients.