Allies for all

As educators and advocates, Dr. Matthew Kesterke and Dr. Faizan Kabani feel obligated to address LGBTIQ+ health disparities in the classroom, community and beyond.

In 2018, Kabani and Kesterke joined forces to research and advocate for a new interprofessional LGBTIQ+ health curriculum, which would be a first in Texas. The change would better equip professional health care students with the skills needed in everyday practice. To get there, they opened the dialogue up to faculty members and students from all Texas A&M Health professional schools—College of Dentistry, College of Medicine, College of Nursing, College of Pharmacy, School of Public Health—as well as the College of Education, and Clinical Learning Resource Center. The response reaffirmed that their mission was needed, and they’ve been meeting virtually since March 2019. That same year, the interprofessional group was recognized by Texas A&M Health with the Teaching Award for Interprofessional Excellence.

“Literature suggests that LGBTIQ+ communities experience a disproportionate amount of health inequalities, including negative experiences with some health care providers, inadequate health insurance benefits, social violence and bullying, higher psychological distress, and more,” Kabani says.

In clinic at the dental school, he says he noticed firsthand how uncomfortable some students were in caring for LGBTIQ+ patients. But instead of seeing a problem, he saw teachable moments and an opportunity to provide “meaningful conversations on cultural sensitivity and compassion,” he says. Through no fault of their own, the students lacked knowledge and experience.

“At first it was disheartening to observe this gap. However, I quickly realized that more organized efforts were needed to help improve the climate at the dental school,” says Kabani, assistant professor and 2020 Dental Hygiene Teacher of the Year.

With more thought, Kabani realized the issue most certainly went well beyond his own realm. He and Kesterke knew something needed to be done on a larger scale. In their advocacy roles for inclusiveness, they had read the statistics about the health care gap the LGBTIQ+ community was experiencing. So they decided to take their concerns to health care colleagues and students at Texas A&M University in College Station.

“One thing I’m really excited about is we have a number of students involved now, including master’s students and Ph.D. students and medical students,” says Kesterke, assistant professor in biomedical sciences. “Getting students involved on ground-level research is very important and it means a lot. All of these colleges are working together.”

Many professional organizations, including the American Dental Education Association, agree that better research and education is needed, Kabani says. A 2018 study underscores that professional health care students are on the same page.

In “Comparing Medical, Dental, and Nursing Students’ Preparedness to Address Lesbian, Gay, Bisexual, Transgender, and Queer Health” (Greene, France, Kreider, Wolfe-Roubatis, Chen, Wu, Yehia, 2018), about 1,000 medical, dental and nursing students’ survey results revealed a general consensus that they believed there is a lack of needed training to address health issues in these populations. Although roughly 70% agreed that they felt comfortable treating LGBTIQ+ patients, less than half believed they were given the formal training needed.

Another study found that related health care curriculum varied widely from one professional school to the next, both in content covered and time invested. In “Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education” (Obedin-Maliver, Goldsmith, Stewart, White, Tran, Brenman, Wells, Fetterman, Garcia, Lunn, 2011), deans at 132 U.S. and Canadian medical schools reported time dedicated to such training was minimal.

Kesterke and Kabani are working to change that, starting with the Texas A&M community. Their first research project included a survey of A&M Health educators to identify gaps in LGBTIQ+ health care education. A second survey will gauge how students have been affected, how well they are taught and their familiarity with LGBTIQ+ issues, Kesterke says. With the results, they hope to coordinate the first interprofessional LGBTIQ+ health curriculum at Texas A&M with a goal to expand that across Texas.

“The ultimate goal is to establish the first-ever Texas A&M center for LGBTIQ+ health education,” Kesterke says.

Kabani and Kesterke presented their thoughts on interprofessional LGBTIQ+ education at a Project ECHO, or Extension for Community Healthcare Outcomes, virtual meeting earlier this summer. They were pleasantly surprised at the warm reception and post-meeting outreach they received from representatives at major universities across numerous states. Many wanted to know how they could use the A&M research to effect change in their own states, Kesterke says.

The reception at the dental school has been equally encouraging.

“A lot of people in the school are interested in contributing and helping out,” he says. “When we gave the Project ECHO presentation, a number of our own dental students showed up. To me, if we can engage students in this sort of research, it is fascinating and rewarding to have them involved.”

For anyone interested in additional LGBTIQ+ information or support, Kesterke recommends the LGBTQ+ Pride Center (Texas A&M campus), the National LGBT Health Education Center and Pronouns Matter.