Intersex inclusion in medical and health education: a review

Intersex people or people with variations in sex characteristics experience health inequity and negative experiences in healthcare. Addressing relevant gaps in medical education is key to improving provider knowledge and competency, to ultimately ameliorate health outcomes for intersex people. The present study undertakes a review to explore the delivery of intersex content in medical education, stakeholder attitudes towards competence in intersex health care delivery, and the success of interventions that address gaps in curricula and students’ perceptions of intersex content. Online databases Scopus, EMBASE, PubMed, ProQuest, and Web of Science were searched for content related to the inclusion of intersex content in medical education. From this, 35 eligible papers were identified and underwent data extraction and analysis. The review found that intersex related content was often included in curricula within the umbrella grouping LGBTQIA+. Inclusion of content was variable geographically and across institutions. An average of two hours was dedicated specifically to intersex and focused mostly on aetiology, diagnosis, and terminology. Students, faculty, and health professionals overall perceived themselves as not competent in intersex knowledge, and related clinical skills and advocacy. However, interventions, when present, improved competency in these domains. Community and student engagement, professional development of staff, and the intentional integration of content longitudinally at ‘teachable moments’, were all key recommendations made by reports into how to create inclusive curricula. Sustainable implementation of intersex-health objectives in medical education should include educational strategies which incorporate lived-experience perspectives, different critical lenses, and non-pathologizing frameworks. This will work to equip students with confidence and competency in knowledge, clinical skills, and advocacy practice that aligns with best-practice models for intersex care, to ultimately improve health outcomes for intersex people.