Sexual Orientation of Medical Students and Influence on Academic Performance and Mental Health

Sexual Orientation of Medical Students and Influence on Academic Performance and Mental Health

Loading document ...
Loading page ...


Author(s): Livia Fratelli, Luis Cesar Fava Spessoto, Fernando Nestor Facio Junior

Download Full PDF Read Complete Article

DOI: 10.18483/ijSci.2595 52 123 1-6 Volume 11 - Aug 2022


Sexuality is a central aspect of being human, though its diversity is not completely accepted in society nor at medical schools. As a consequence, minority medical students face discrimination, poorer mental health, loneliness and worse academic performance. Objective: To investigate the sexual diversity of medical students and its possible influence on academic performance and mental health. Method: A descriptive cross-sectional study was conducted involving 187 undergraduate students of medicine. They answered a self-administrated multiple-choice questionnaire about their demographic characteristics, assigned sex at birth, sexual orientation, gender identity, whether sexual orientation and/or gender identity interferes with academic performance and whether they conceal their sexual orientation and/or gender identity. Participants also responded the Depression, Anxiety and Stress Scale (DASS-21) and questions about discrimination an loneliness. Results: Of the 187 undergraduate students of medicine that answered the questionnaire, 37,4% were LGBTQIA+ (lesbian, gay, bisexual), 62.5% were heterosexual and 100% were cisgender. Reported not openly assuming their sexuality 31.42% of the minority students. LGBTQIA+ accounted for 95, 72.90 and 81.82% of the students with extremely severe depression, anxiety and stress, respectively. Bisexual accounted for 63.63, 67.74 and 55.55% of LGBTQIA+ students with extremely severe depression, anxiety and stress, respectively. The majority of LGBTQIA+ students frequently felt alone (70%), isolated (72.85%) or excluded (68.58%). Most students (92.5%) reported their sexual orientation and/or gender identity did not affect their studies. Conclusion: LGBTQIA+ medical students present worse mental health (depression, anxiety and stress) and feel more excluded. Among them, bisexuals present greater vulnerability. Most medical students report their sexual orientation does not interfere with academic performance.


Schools, Medical, Academic Performance, Sexual Minority, Mental Health


  1. Sexual health, human rights and the law. Geneva: World Health Organization; 2015.
  2. FAQ on Health and Sexual Diversity - An Introduction to Key Concepts. Geneva: World Health Organization; 2016.
  3. Mansh M, White W, Gee-Tong L, Lunn MR, Obedin-Maliver J, Stewart L, et al. Sexual and gender minority identity disclosure during undergraduate medical education: “in the closet” in medical school. Acad Med. 2015;90(5):634-44.
  4. Hill KA, Samuels EA, Gross CP, Desai MM, Zelin NS, Latimore D, et al. Assessment of the prevalence of medical student mistreatment by sex, race/ethnicity, and sexual orientation. JAMA Intern Med. 2020;180(5):653-65.
  5. Przedworski JM, Dovidio JF, Hardeman RR, Phelan SM, Burke SE, Ruben MA, et al. A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students: a report from the medical student CHANGE study. Acad Med. 2015;90(5):652-9.
  6. Samuels EA, Boatright DH, Wong AH, et al. Association Between Sexual Orientation, Mistreatment, and Burnout Among US Medical Students. JAMA Netw Open. 2021;4(2):e2036136.
  7. Sacramento BO, Anjos TL, Barbosa AGL, Tavares CF, Dias JP. Symptoms of anxiety and depression among medical students: study of prevalence and associated factors. Rev Bras Educ Med. 2021;45(1):e021.
  8. Vignola RCB, Tucci AM. Adaptation and validation of the Depression, Anxiety and Stress Scale (DASS) to Brazilian Portuguese. J Affect Disord. 2014;155:104-9.
  9. Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.
  10. Clark R, Coleman AP, Novak JD. Brief report: Initial psychometric properties of the Everyday Discrimination Scale in black adolescents. J Adolesc. 2004;27:363-8.
  11. Russell D. UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20-40.
  12. Suppes, A., van der Toorn, J., & Begeny, C. T. Unhealthy closets, discriminatory dwellings: The mental health benefits and costs of being open about one’s sexual minority status. Social Science & Medicine. 2021; 285, 114286.
  13. Feinstein, B. A., Xavier Hall, C. D., Dyar, C., & Davila, J. Motivations for Sexual Identity Concealment and Their Associations with Mental Health among Bisexual, Pansexual, Queer, and Fluid (Bi+) Individuals. Journal of Bisexuality. 2020; 1–18.
  14. Castañeda M. A experiência homossexual: explicações e conselhos para os homossexuais, suas famílias e seus terapeutas. São Paulo: A Girafa; 2007.
  15. Grossman AH, D'Augelli AR. Transgender youth: invisible and vulnerable. J Homosex. 2006;51(1):111-28.
  16. Visgueira, Filipe Levy Leite et al. Análise do conhecimento de estudantes de medicina acerca da identidade de gênero. Revista Brasileira de Educação Médica [online]. 2021, v. 45, n. 04.
  17. Barbosa, Matheus Ghossain, Silva, Magnus Régios Dias da and Seródio, Aluísio Marçal de BarrosTransgender Population under the Bioethics Perspective: a Panorama of the Curricula and Bioethics Courses of Medical Schools of the State of São Paulo. Revista Brasileira de Educação Médica [online]. 2020, v. 44, n. 03.
  18. Danon, Carlos Alberto Ferreira, Conceição, Kauan Rodrigues and Daltro, Mônica RamosBrazilian Journal of Medical Education and the Health of Transgender People. Revista Brasileira de Educação Médica [online]. 2020, v. 44, n. 2.
  19. Weiss J, Balasuriya L, Cramer LD, Nunez-Smith M, Genao I, Gonzalez-Colaso R, Wong AH, Samuels EA, Latimore D, Boatright D, Sharifi M. Medical Students' Demographic Characteristics and Their Perceptions of Faculty Role Modeling of Respect for Diversity. JAMA Netw Open. 2021; 4(6):e2112795.
  20. Ramírez, E. G. L., Delgado, Y. K., Volpato, R. J., de Claudio, J. C. M., Pinho, P. H., & de Vargas, D. Prevalence of suicidal ideation in gender and sexual minority students in the largest Brazilian University. Archives of Psychiatric Nursing. 2020.
  21. Flesch, Betina Daniele et al. Major depressive episode among university students in Southern Brazil. Revista de Saúde Pública [online]. 2021; v. 54.
  22. Lo Moro G, Bert F, Gualano MR, Leombruni P, Siliquini R, PRIMES Collaborating Group. Exploring depressive symptoms among LGBT+ medical students: an Italian multicentre survey. Eur J Public Health 2020;30(Suppl 5):v105.
  23. Brasil. Ministério da Saúde. Secretaria de Gestão Estratégica e Participativa. Política nacional de saúde integral de lésbicas, gays, bissexuais, travestis e transexuais. Brasília: Ministério da Saúde; 2013.
  24. Ross LE, Salway T, Tarasoff LA, MacKay JM, Hawkins BW, Fehr CP. Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals:a systematic review and meta-analysis. J Sex Res. 2018;55(4-5):435-56.
  25. Snowdon S. Recommendations for Enhancing the Climate for LGBT Students and Employees in Health Professional Schools. Washington, DC: GLMA; 2013.
  26. Sánchez NF, Rankin S, Callahan E, Ng H, Holaday L, McIntosh K, et al. LGBT trainee and health professional perspectives on academic careers—facilitators and challenges. LGBT Health. 2015;2(4):346-56.
  27. Butler K, Yak A, Veltman A. “Progress in medicine is slower to happen”: qualitative insights into how trans and gender nonconforming medical students navigate cisnormative medical cultures at Canadian training programs. Acad Med. 2019;94(11):1757-65.
  28. Raimondi, Gustavo Antonio et al. Gender and Sexuality in the Federal Medical Schools in Brazil: an Analysis of the Curricular Pedagogical Projects. Revista Brasileira de Educação Médica [online]. 2020, v. 44, n. 2, e 045.

Cite this Article:

International Journal of Sciences is Open Access Journal.
This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Author(s) retain the copyrights of this article, though, publication rights are with Alkhaer Publications.

Search Articles

Issue June 2023

Volume 12, June 2023

Table of Contents

World-wide Delivery is FREE

Share this Issue with Friends:

Submit your Paper