A preclinical educational session on gender identity in the medical interview for first year medical students

Sexual and gender minority (SGM) patients experience profound health disparities, yet preclinical medical education often provides insufficient training in inclusive clinical communication. Students frequently lack the clinical frameworks, terminology, and communication skills needed to conduct gender-affirming medical interviews. We developed and implemented a 90-minute interactive lecture and case-based practice activity on gender identity in the medical interview as part of the Practice of Medicine (POM) course at Harvard Medical School. Delivered by faculty in the Sexual and Gender Minority Health Equity Initiative, the session covered foundational sexual orientation and gender identity (SOGI) terminology, pronoun use, trauma-informed communication, anatomic inventories, and EHR-based SOGI documentation. The primary outcome was within-student change in self-reported understanding and confidence, measured via an 18-item, 5-point Likert-scale pre/post survey administered to first-year medical students ( n = 94 pre-survey submissions, 92 with unique identifiers; n = 21 post-survey submissions; n = 18 matched pairs). Among 18 matched pairs (17 with item-level data), self-reported ratings increased on 11 of 18 items (Wilcoxon signed-rank test, p < 0.05) and on 8 of 18 after Benjamini-Hochberg adjustment ( q < 0.05). The largest gains were in comfort asking patients about correct names and pronouns ( Δ = +1.29, p = 0.004), completing an anatomic inventory ( Δ = +1.35, p = 0.003), conducting patient education on sex and gender ( Δ = +1.41, p = 0.001), and responding to patients who object to pronoun questions ( Δ = +1.41, p = 0.004). A single preclinical interactive session was associated with improved self-reported confidence in gender-affirming communication among first-year medical students; 8 of 18 items remained significant after false discovery rate adjustment. These findings reflect students’ perceptions of their own understanding and confidence and do not establish change in clinical performance. Future work should address EHR-based SOGI documentation skills and evaluate longitudinal behavior change through standardized patient assessments. Not applicable.