title: Still in the closet: the invisible minority in medical education.
abstract: BACKGROUND
  To investigate the relationship between sexual orientation and gender identity in regard to levels of depression; levels of perceived social support; comfort with disclosure of orientation; and the lesbian, gay, bisexual, and transgender (LGBT) campus climate.
  
  
  METHODS
  E-mail invitations to participate in the current cross-sectional questionnaire-based study were sent to all thirty US osteopathic medical schools in August 2012; six schools responded and disseminated the survey to their students. Participating students completed an anonymous web-based survey, and informed consent was obtained when they accessed the survey. The survey was designed specifically for the current study but contained scales used with permission from previously published research. Analysis procedures included nonparametric tests, one-way analysis of variance and Pearson's correlations.
  
  
  RESULTS
  Of the 4112 students invited to participate in the survey, 1334 (32.4%) completed it. Approximately 85% of respondents self-identified as heterosexual only. No respondents identified as transgender. In general, LGB students indicated higher levels of depression (P < .001), slightly lower levels of perceived social support (P < .001), and more discomfort with disclosure of sexual orientation (P < .001). A majority of students rated their campus climate as noninclusive.
  
  
  CONCLUSIONS
  Results of the current study indicated a relationship between sexual orientation and depression, perceived social support, comfort with disclosure of orientation, and the LGBT campus climate in osteopathic medical students. In the future, osteopathic medical schools should consider closely examining their campus culture in order to create a more positive and inclusive environment for all its students.
authors.affiliation: A,T, Still University, Kirksville College of Osteopathic Medicine, Kirksville, Missouri, USA. jlapin9@gmail.com.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lapinski
authors.forename: Patricia
authors.initials: P
authors.lastname: Sexton
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004501:Education, Medical / Q000706:statistics & numerical data; D005260:Female; D018452:Homosexuality, Female / Q000523:psychology / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012577:Schools, Medical / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012944:Social Support; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D000078329:Workforce; D055815:Young Adult