The United States has been making great strides in their acceptance for the LGBTQQI (lesbian, gay, bisexual, transgender, queer, questioning, intersex) community. However, they still face an unfortunate lack of the same healthcare treatment as the rest of the population. The LGBT community is diverse with people of all ages, socioeconomic status, ethnicities, races and personal identities. However, these members of this motley crew all share similar experiences with limited access to healthcare riddled with bias, a lack of eduation and a history of poor treatment.
It’s time to change our healthcare to match our society’s increasing social acceptance.
LGBT community members have a harder time accessing health care. For example, same-sex relationships are much less likely than heterosexual ones to gain insurance through their partner’s employer-sponsored health plans. This can cause issues in getting basic healthcare needs met such as yearly gynecologist visits for women. Work-provided health insurance benefits are limited for same-sex partners/spouses which may be part of the reason that females in same-sex relationships are more likely to be overweight, homosexual males have higher instances of eating disorders, LGBT members have big concerns about sexually transmitted infections, and differences in regard to prevalence of mental disorders and substance abuse. For example, members of the LGBT population are about two times as likely to smoke cigarettes than the general population. This may be due to what is known as “minority stress” that may cause these individuals to cope with their either real or expected experiences of homophobia and other prejudices that might cause anxiety or depression.
Making your practice LGBT friendly isn’t rocket science. But, implementing policies that make a positive change for the LGBT community is a way to make one small step for LGBT-kind and a HUGE leap for the growth and understanding of your office. The best way you can treat all patients equally right from the start is firstly by creating a welcoming environment. According to one report, LGBT patients usually look around for cues that might help them understand whether they are in an accepting place or not. If you add minor changes to signage, the standard forms given and just general office practices.
Intake forms are the first place a practice should start to give patients comfort during their medical visits. When these initial forms are revised in a way that is accepting of all gender identities and sexual preferences, it may increase the likelihood that LGBT patients will feel safe enough discussing their health and behaviors with your staff.
3 Questions to Ask to Gather Gender Identity
- “What is your current gender identity? (Check ALL that apply): Male, Female, Transgender Male/Trans Man/FTM, Transgender Female/Trans Woman/MTF, Genderqueer, Additional Category (please specify), and Decline to Answer.”
- “What sex were you assigned at birth? (Check one): Male, Female, or Decline to Answer.”
- “What pronouns do you prefer? (Open-ended question.)”
Another way to create an open and trusting environment for members of the LGBT community is to completely avoid making assumptions about a patients gender or sexual orientation based off of behavior. Instead, physicians and nurses need to mirror the pronouns that the patient themselves refers to themselves at and to ask open ended questions to avoid jumping to conclusions or possibly offending someone. Instead of asking is they are married or have a boy/girlfriend, ask if they have a partner. This way you can still start an open talk about their current sex life without clinicians making a mistake of simply assuming heterosexuality.
Physicians may not all be experts in LGBT health issues. However, clinicians should pursue gaining more information about formally treating this population. At this time, there still is a huge lack of training in North American medical schools for taking care of members of this group.
It’s about time we realize that the success of our healthcare systems rely on being able to understand the cultural differences (and similarities) LGBT patients require so that we can effectively serve them in inclusive and non-judgmental environments. We need to put into place altered policies to give all our patients personally-centered care so that issues such as transgender care, behavioral health, STI prevention and just plain primary care doesn’t get set to the wayside.
For more information on making your practice more friendly and welcoming for all, visit the National LGBT Health Education Center website.