'Im looking as white and as straight as possible at all times: a qualitative study exploring the intersectional experiences of BAME LGBTQ+ medical students in the UK

Objectives
The positive formation of professional identity is considered crucial in how medical students begin to feel and act as clinicians. Although, awareness of how Professional Identity Formation (PIF) may be affected among minoritised groups is increasing, understanding from an intersectional lens remains limited. The aim of this study was to explore the experiences of Black, Asian, Minoritised Ethnic (BAME) and Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) medical students in the undergraduate Bachelor of Medicine, Bachelor of Science programme.

Design
Based on the methodology of phenomenography, all medical students identifying as BAME and LGBTQ+ were eligible for participation. Semistructured interviews were conducted with data collection continuing until theoretical saturation was reached. The coding framework was developed independently by the principal researcher and supervisor before being compared to create a shared analytical framework.

Setting
University College London Medical School (UCLMS) between October 2022 and February 2023.

Participants
Six UCLMS students were recruited, one of whom was in the ‘early’ years (years 1–3) with the remainder in the ‘later’ years (years 4–6)

Results
Six main themes emerged from the data, which were categorised into three main areas: challenges to intersectionality, benefits to intersectionality and protective factors. Challenges to intersectionality included three themes, ‘The BAME identity interacting with the LGBTQ+identity’, ‘BAME background influencing LGBTQ+identity exploration’ and ‘no true safe spaces for BAME and LGBTQ+ students to be themselves’. Benefits to intersectionality included ‘greater insight into the self’ and protective factors included two themes of ‘peer support networks’ and ‘visibility within the university and clinical environments.’

Conclusion
By exploring PIF among medical students from an intersectional lens, this study highlights the increased emotional burden faced by those who identify as BAME and LGBTQ+, as they attempt to reconcile both these identities with becoming a future doctor, affecting their sense of belonging socially and within the profession. Despite being based at a single medical school, it highlights the importance of creating a truly inclusive environment through positive role modelling and increased visibility among the BAME, LGBTQ+ community in the undergraduate programme.

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Qualitative exploration of uterine cancer care for lesbian, gay, bisexual, trans and queer (LGBTQ+) patients in the UK: shifting from equality to equity

Objective
Patients identifying as lesbian, gay, bisexual, transgender and/or queer/questioning (LGBTQ+) report significant disparities in cancer care and are disproportionally affected by a cancer diagnosis on a number of health-related indicators. This study aimed to explore uterine cancer (UC) care from the perspectives of LGBTQ+ patients and stakeholders, to identify this population’s care needs, which have been underprioritised thus far.

Methods and analysis
Qualitative interview data were collected from three cohorts of participants: LGBTQ+ UC patients, partners of UC patients and stakeholders who provide advocacy and/or support within the UC care pathway, including healthcare professionals (HCPs). Semi-structured qualitative interviews were conducted and data were analysed using inductive reflexive thematic analysis.

Results
Fifteen participants (three patients, one partner, eight HCPs and three cancer support charity representatives) were recruited. Data analysis identified themes which represented participants’ reflections on the relevance and opportunities for identity disclosure during the diagnostic pathway; feelings and implications of not fitting into the gynaecological cancer environment and, opportunities and challenges surrounding HCP education, and protocolled sexual and gender identity data collection.

Conclusion
UC patients who identify as LGBTQ+ have specific care needs and considerations, particularly related to transvaginal procedures and survivorship. Opportunities for disclosure of patients’ LGBTQ+ identity during the UC care pathway are essential for these needs to be recognised. Despite this, there are conflicting agendas between HCPs and stakeholders on the best approach to integrate disclosure processes. The current findings highlight the need for public health agendas and clinical services to address the needs of LGBTQ+ UC patients.

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Otite media acuta

Riferimenti: Pagina di riferimento AIFA: https://www.aifa.gov.it/farmaci-antibiotici Edizione italiana del “The […]

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Association of Political Assaults With the Health of Transgender and Nonbinary Persons

Until recently, we could not begin to understand the health and well-being of transgender and nonbinary communities. The rampant practice of erasing transgender and nonbinary populations in public health and scientific programming and data collection systems guaranteed that transgender and nonbinary communities were invisible. To rectify this, numerous institutions, such as the National Institutes of Health; National Academies of Sciences, Engineering, and Medicine; US Office of Science and Technology Policy; and US Office of Management and Budget, have called for improved data collection to facilitate greater understanding of the health and well-being of transgender and nonbinary populations and of how gender identity shapes opportunities, experiences with discrimination, and outcomes through the life course. Consequently, a more detailed picture of self-reported gender identity is now available, providing not only a single snapshot but also a composite image of the health of the transgender and nonbinary population over time. What we are seeing in the data are the harms of policies directed against transgender and nonbinary people.

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