Creation and Pilot of a Student-Led, Gender-Affirming and LGBTQIA+-Focused Sexual Health Care Clinic in Miami, FL.

IntroductionThe LGBTQIA+ community faces substantial barriers to healthcare access, contributing to disproportionate rates of HIV and sexually transmitted infections, limited uptake of pre-exposure prophylaxis (PrEP), and inadequate access to gender-affirming hormone therapy (GAHT). A root cause is the lack of LGBTQIA+-focused training in US medical curricula, with a median of only five hours dedicated across four years of medical school. From January through December 2024, a student-run gender-affirming care and infectious disease clinic was piloted at an academic medical institution in South Florida. The objective of this implementation study is to report on clinic implementation, patient outcomes, and stakeholder feedback.MethodsThe clinic provided GAHT, HIV and sexually transmitted infections prevention and testing, including PrEP, nPEP, and DoxyPEP to an LGBTQIA+ patient population at no cost. Five medical student officers led operations alongside 38 student volunteers, 6 attending physicians, and 4 residents. Qualitative interviews informed by the Consolidated Framework for Implementation Research (CFIR) were conducted with four key stakeholders following the pilot.ResultsThe clinic served 42 patients. Among 36 patients receiving GAHT, 63.9% also received PrEP. Patient retention was high: 85.4% returned for follow-up within 90 days, 97.6% picked up medications after the first visit, and 82.9% continued regular medication pickup. Qualitative stakeholder perspectives centered on responsiveness to the political climate and local need, effective clinical care with high patient satisfaction, a supportive learner culture, and potential for program expansion.ConclusionsThis pilot demonstrates the feasibility and impact of student-led, gender-affirming sexual health clinics and provides a replicable framework for other institutions. Grant funding is being pursued to re-establish and expand services with an integrated psychiatric component tailored to LGBTQIA+ populations.