LGBTQIA+ Cultural Competency of Psychiatrists in an Indian State: A Cross-Sectional Study

Indian studies have highlighted medical students' negative attitudes toward LGBTQIA+ individuals and a lack of LGBTQIA+-informed training. However, no study has assessed the LGBTQIA+-cultural competency of Indian psychiatrists. This cross-sectional study assessed the cultural competency of psychiatrists in Kerala, an Indian state, and explored its association with relevant sociodemographic and experiential variables. LGBTQIA+ cultural competency was measured using the LGBT Development of Clinical Skills Scale (LGBT-DOCSS). Data were collected through stratified convenience sampling, in-person at psychiatry meetings and online through WhatsApp. Participants (N = 166) had a moderate overall LGBT-DOCSS score (mean ± SD: 5.03 ± 0.80). Subscales showed moderate knowledge (median: 5.50, IQR: 2), high attitudinal awareness (median: 6.14, IQR: 1), and low clinical preparedness (3.88 ± 1.43). LGB (5.16 ± 0.83) and transgender (5.02 ± 0.85) cultural competencies were moderate. Most participants (n = 160, 96.4%) treated < 5 LGBTQIA+ patients per month, and only 16 (9.6%) had received LGBTQIA+-informed training. Age (ρ = -0.18, p = 0.018) and religiosity (ρ = -0.23, p = 0.002) were significantly negatively correlated with cultural competency. Psychiatrists who treated < 5 LGBTQIA+ patients per month demonstrated significantly lesser cultural competency than those who treated 5-10 (t = -2.78, p = 0.033). Psychiatrists in Kerala have moderate LGBTQIA+ cultural competency, with high attitudinal awareness, moderate knowledge, and low clinical preparedness. This study highlights the need for comprehensive cultural competency training.