Background: Asexuality (ace), aromanticism (aro), and agender (agen) (“a-spec” identities, the “A” in LGBTQIA+) are rarely included in medical training. As Family Medicine Physicians (FMPs) care for patients of all ages and identities across the lifespan, awareness, knowledge, acceptance, and care for a-spec patients is a critical component of our work.

Objective: We surveyed UCLA Health FMPs to determine factors informing comfort and knowledge related to a-spec patients.

Methods: We emailed an anonymous 34-question online survey to 252 UCLA Health FM attendings and residents. We received 92 responses and excluded 5 (2 repeats, 3 noncompleted). 5-point Likert scales assessed comfort, knowledge, clinical practice, normativity biases, and misconceptions relating to the a-spec community. Results were quantified using descriptive frequencies. Differences in comfort and knowledge regarding a-spec patients were compared using chi-square and Kruskal-Wallis tests based on: Prior LGBTQIA+ training; Relationship to the LGBTQIA+ community; Exposure to a-spec patients; and Residency completion date.

Results: Most respondents were 25-40 years old, White, female, Attendings who finished residency within 5 years. 40.3% had close LGBTQIA+ community ties and 19.5% identified as LGBTQIA+. Prior LGBTQIA+ training was associated with familiarity with ace and aro; Caring for > 1% a-spec patients was positively associated with comfort treating a-spec patients and addressing a-spec health concerns. LGBTQIA+ community ties were associated with preference to address a-spec concerns; and completing residency before 2020 with knowledge of breast cancer screening recommendations for agen patients. LGBTQIA+ ties were associated with awareness of ace microlabels and a-spec informative websites. Recently finishing residency was associated with recognizing aro microlabels.

Conclusions: Despite comfort in caring for a-spec patients among UCLA FMPs, we found persistent deficits in training that could be improved with a-spec specific training that incorporates a-spec voices.