LGBTQ+ care knowledge, attitudes, and comfort among European healthcarestudents: an Italian survey

Abstract

Abstract Background Across Europe, LGBTQI+ populations experience persistent health inequalities. Inadequate training of healthcare professionals still represents a major obstacle. However, data on preparedness of students remain limited. This study aimed to assess knowledge, attitudes, comfort and self-perceived competence of healthcare students regarding LGBTQI+ health. Methods A cross-sectional study was conducted among medical and nursing students at the University of Turin (Italy) through an anonymous questionnaire (2024-2025). Outcomes included a composite knowledge score (0-21), attitude items, a comfort scale (1–4), and a self-competence scale (1–5). Higher scores indicated greater levels of knowledge, comfort, and self-competence. Multivariable regressions were fitted. Results Participants were 554 (69.1% medical, 30.9% nursing). Mean knowledge score was 14.0±2.7 among medical and 12.9±2.4 among nursing students (p < 0.001). Positive and inclusive attitudes were reported by 37.4% of the sample; mean comfort was 3.43±0.57 and self-perceived competence 3.13±0.64. Preliminary analyses showed that nursing students had significantly lower knowledge compared to medical students (β − 1.15; p < 0.001). Clinical training exposure was positively associated with knowledge (β = +0.81; p = 0.005), as was identifying as LGBTQI + (β = +1.69; p < 0.001). Higher levels of religiosity and a right-wing political orientation were associated with lower knowledge and reduced comfort. Conclusions Findings highlight a consistent European challenge: despite generally positive attitudes, students showed moderate knowledge and limited comfort and self-perceived competence in LGBTQI+ health. Educational exposure and socio-cultural factors may shape preparedness. Integrating standardized, competency-based LGBTQI+ health education into European health curricula should be considered a priority to advance equity and quality of care. Key messages • In an Italian survey of 554 healthcare students, knowledge gaps and limited comfort in LGBTQI+ care persisted across medical and nursing programs, reflecting a broader unmet educational need in Europe. • Clinical training and LGBTQI+ identity boosted knowledge, while religiosity and right-wing orientation reduced it, showing that preparedness is shaped by training and sociocultural factors.