• Despite the need for moderately favourable attitudes, medical students' show poor knowledge on LGBT people

Even though socio-demographic factors such as their sex, marital status and home town, and professional factors such as the years of service and the university from which they graduated from, have no impact on the attitudes of medical officers (MOs) towards lesbian, gay, bisexual and transgender (LGBT) people, increased religiosity however has a negative impact on their attitudes towards the LGBT community.

This observation was made in an undergraduate student oral presentation on the "Knowledge and attitudes of MOs on the health care needs of LGBT people" which was authored by U.H.S.N. Wijerathne, S. Wijesekara, D.A.T.V. Wijesekara and W.M.A.C. Wijesundara (all four attached to the Colombo University's Medical Faculty) and N. Chandraratne (attached to the same Faculty's Community Medicine Department) and made at the second session of the Ceylon Medical Congress (CMC) and was published in the Ceylon Journal of Medical Science' as an abstract in the CMC Editorial Board for 2022’ "List of oral presentations and poster presentations" in its 59th Volume in November, 2022. 

To avoid hostility

The LGBT community, being a sexual minority, is subjected to discrimination in health care settings due to the lack of knowledge and development of hostile attitudes among health care professionals.

This study by Wijerathne et al. was carried out as a descriptive, cross sectional study with the participation of 112 MOs from two selected hospitals in Sri Lanka. Data were collected through an online, self administered questionnaire made by the amalgamation of the modified Sex Education and Knowledge about Homosexuality Questionnaire and Attitudes towards Homosexuality Questionnaire.

The response rate was 97.3%. Out of 109 MOs, the majority had a good level of knowledge (70.6%) and attitudes (94.5%) towards LGBT people. Furthermore, a moderate, positive and linear correlation was noted between knowledge and attitudes. Socio-demographic factors such as sex, marital status and the hometown of the participants and professional factors like the years of experience and the university from which they graduated from, showed no association with their related attitudes, but a strong association between religiosity was determined based on a subjective question and negative attitudes were noted.

The knowledge and attitudes of MOs in the selected hospitals are satisfactory and therefore, knowledge is likely a tool in shaping attitudes towards the LGBT community.

In a different vein, earlier, a poster presentation under public health and primary care on "Attitudes towards homosexuality, bisexuality and transgenderism among medical students of a Sri Lankan University" made by J.S.R.L. Rajapaksha, R.G.D.T. Rajapaksha, A.U.R. Ranawaka, R.D.M.P. Rangalla, R.D.E.B. Ranwala and M.N. Chandratilake at the third session of the proceedings of the 30th anniversary academic session conference of the Kelaniya University's Medical Faculty in 2021, found that although medical students' knowledge on the sexuality and gender related basis of LGBT people is poor, they have moderately favourable attitudes towards them.

LGBT patients experience discrimination, insensitivity and ignorance when it comes to LGBT specific health needs among health care providers. Hence, developing the correct attitudes among medical students towards LGBT people may help provide them with optimal health care.

Preference vs. reality

This cross sectional, descriptive study by Rajapaksha et al. was conducted among all the medical students in the Kelaniya University's Medical Faculty. A validated online questionnaire was used.

A total of 358 completed the survey. Their attitudes on the traditional gender role and comfortability in interacting with LGBT people were moderate and they disagreed with negative LGBT related social beliefs. They knew less about the origin of sexuality and gender of LGBT people. Although they accepted being LGBT as a part of diversity, they discouraged normalising the social practices of LGBT people. Their acceptance of and association with LGBT people was moderately positive. A minority had encountered LGBT people in close social circles while the majority of them were batch mates. Although males' knowledge about the origin of being LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of the attitudes towards LGBT people reflected the respondents' political ideology.

They accepted LGBT people as a part of social diversity but not their social practices. It was concluded therefore that poor knowledge, the lack of encounters, cultural influences and political ideology may have influenced their attitudes.

A recent study sponsored by the United Kingdom Government's Foreign, Commonwealth and Development Office suggested that related attitudes may be changing and that those with a more positive attitude towards LGBT people are likely to be under 30 years of age, living in urban areas, educated to tertiary levels or higher, having a higher level of awareness of LGBT identities, reporting more interaction with LGBT people and likely to follow Buddhism or Hinduism while a study conducted by The Social Scientists Association for the Westminster Foundation for Democracy in 2020 covering all 25 Districts of Sri Lanka with a sample of 2,130 people from a population of diverse genders, ages, education levels and religious groups, noted however that positive and negative perceptions are held depending on a particular issue and context. 59.7% said that they will not be ashamed to travel next to a gay or lesbian person; 49.5% agreed that it would be shameful for a transgender person to be the President of Sri Lanka while 48% disagreed; 72.5% said that a person living life as a LGBT person should not be punished for their sexual identity; 65% said that a LGBT person can do a job as well as any other person; 51.4% said that they would support legislation to ensure the rights of LGBT persons; 59.5% said that renting their house to a LGBT person would be a problem; 48.6% said that it would not be shameful to have a LGBT child while 44.4% said that it would; 51.4% said that LGBT goes against their religion; 52.3% said that association encourages a person to become like them while over 40% disagreed; 89% said that LGBT persons face violence and abuse on social media; 87% said that LGBT persons face discrimination in finding rental housing and/or in school; and 69% said that LGBT persons face discrimination by the Police), which in turn suggests that there is work to be done to address stigma and stereotypes and to build knowledge and awareness.