Current State of LGBTQIA+ Health Education in Low- and Middle-Income Countries: A Narrative Review of Educational Gaps in Transgender, Intersex/Differences of Sex Development (DSD), and Sexual and Gender Minority Healthcare.

Sexual and gender minorities, LGBTQIA+ individuals, transgender individuals, and intersex individuals represent a small proportion of the population and encompass diverse sexual preferences, gender identities, sexual characteristics, and gender expressions. These individuals often present with unique health needs due to biological differences in anatomy, physiology, or genetic sexual characteristics. Despite these differences, education regarding their healthcare is insufficient in medical curricula worldwide, specifically in low- and middle-income countries (LMICs). Medical students are often unaware of the specific needs of these individuals and, hence, show a willingness to learn more so that they are better equipped clinically. Health care providers (HCPs) often lack the required knowledge and may behave unprofessionally toward these patients. This may include marginalisation, discrimination, and non-consensual examinations. Such instances make these individuals less likely to seek medical care. Thus, there is a dire need to integrate content about their healthcare needs into medical education and clinical practice in LMICs to prevent unprofessional conduct and improve health outcomes. This review highlights the existing literature on the educational and clinical preparedness of medical students and HCPs related to the healthcare needs of the LGBTQIA+ population, with a specific focus on intersex/differences of sex development (DSD) individuals, and accordingly puts forward recommendations for improvement.