Document Type

Article

Publication Date

3-10-2026

Abstract

Background

While attempts to diversify the physician workforce are ongoing, limited research exists exploring the experiences LGBTQIA+ medical students during their preclinical training. The purpose of this study is to examine how interpersonal interactions, campus climate, and the availability of campus support influence the well-being of LGBTQIA+ medical students across U.S. medical schools during their preclinical education.

Method

Medical students self-identifying as LGBTQIA + and enrolled in either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) institutions in the U.S. in 2024 completed an online, 136-item survey. Participants were asked about preclinical medical school experiences, perceptions of their campus climate and curriculum, and perceived level of impact experiences had on their well-being.

Results

Four hundred fourteen completed records were analyzed, representing LGBTQIA+ medical students across MD (n = 295, 71.3%) and DO (n = 119, 28.7%) programs, including 309 cisgender (74.6%) and 97 (23.4%) transgender or gender-expansive (TGE) students. The majority of participants indicated that their school fell short in providing supportive diversity initiatives, LGBTQIA+ specific spaces, positive LGBTQIA+ representation, and adequate responses to discrimination. Most participants also reported that professors did poorly at using inclusive terminology and advocating for LGBTQIA+ inclusion. TGE students consistently rated their school, classmates, professors, and campus climate lower than cisgender students, and were significantly more likely to report differential treatment (55.7% vs. 23.3%, p < .001) and overt harassment (23.7% vs. 4.5%, p < .001). Students in red states or rural settings reported significantly less inclusivity and campus support than those in blue states or urban settings.

Conclusions

LGBTQIA+ medical students face significant barriers to well-being, including adverse campus experiences, inadequate support, and limited inclusivity. This study highlights an acute need for interventions that improve the preclinical environment for LGBTQIA+, and particularly TGE, medical students.

Publication Title

BMC Medical Education

PubMed ID

41803766

Comments

This article was published in BMC Medical Education.

The published version is available at https://doi.org/10.1186/s12909-026-08966-6.

Copyright © 2026 The Author(s). CC BY 4.0.

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