Living with Chronic Pain
Guidance on Providing Inclusive Health Care to the LGBTQIA+ Community
There are many barriers the LGBTQIA+ community faces concerning accessing inclusive health care. This can include medical trauma, high poverty rates, discrimination, lack of comprehensive care, etc. Not only can these factors impact the accessibility and quality of health care received in the LGBTQIA+ community, but it can also adversely affect mental and physical health.
Health care professionals should eliminate these barriers and provide the best care for all members of the community they serve. For those not familiar with the LGBTQIA+ community (or certain subsets), it may be difficult to know where to begin. A medical provider can offer a welcoming, accessible environment to the LGBTQIA+ community, while remaining mindful of barriers and taking steps to remove them.
Unfortunately, many medical forms contain outdated terminology, lack selective options, or exclude important information. Inclusive language on intake forms helps ensure that members of the community stay engaged in their health care. Many practices are guilty of combining sex and gender, not providing a place for a chosen name or pronoun, or omitting options about sexuality or gender. The assigned sex at birth may be different from the legal sex, which may also differ from the gender. Various sections of necessary information on the form should include as many options as needed or offer a write-in option.
The chosen name and pronoun on a form should be used by health care providers when addressing individuals. A significant amount of distress can occur if a person is referred to by the wrong name or pronoun. Transgender people, who experience this at a higher rate or multiple times each day, have feelings of dysphoria, which can cause long-term mental health issues. Experiencing repeated misgendering or “deadnaming” (being referred to by the wrong name) is likely to deter a person from seeking needed care in order to avoid psychological distress.
Oftentimes, health care providers do not intend to be discriminatory or exclusive of LGBTQIA+ individuals. Instances of bias may arise due to lack of education. Mandatory sensitivity training can help educate staff members on outdated language or practices. Having educated staff members provides a welcoming environment to members of the LGBTQIA+ community.
Frustration occurs when health care professionals are unable to answer certain questions, such as those pertaining to hormone replacement therapy (HRT), practicing safe sex, testing for sexually transmitted infections (STIs), etc. This may be due to lack of overall research on certain subjects. However, it is oftentimes because the provider has a limited understanding of the subject, even when information is well-researched and readily available. Having an overall understanding of LGBTQIA+ health care is essential for all providers.
Although members of the LGBTQIA+ community have many common experiences, they are all different and have unique needs. Asking about preferences and experiences is a fail-safe way for a provider to know what language they should use to identify or refer to a patient. It also helps to determine their needs and avoid confusion that may arise based on assumptions.
Members of the LGBTQIA+ community have higher rates of trauma; therefore, it is common for them to have certain needs when seeking health care. A provider that is not trauma-informed is likely to unintentionally treat their client in a harmful way. This can impact the quality of care they receive and make it less likely for them to seek care in the future. Providing trauma-informed training to staff can help eliminate this barrier.
Signs signifying a “safe space” or “LGBTQIA+ Welcome” are being hung up in an increasing number of physician’s offices around the world. These signs allow members of the LGBTQIA+ community to know that they are welcome and will be met by caring staff. It also reinforces the fact that they will be listened to and their best interests will be recognized.
Do not place blame
For many transgender individuals specifically, it is common to have a symptom blamed on either the effects of their gender-affirming care or the fact that they are transgender. Many health care professionals dismiss symptoms, that would otherwise raise alarm, simply because their patient is transgender. This causes skepticism of receiving inclusive health care. When a transgender person has concerns about their health, they should receive the same tests and care as others with the same symptoms. This helps prevent misdiagnosis or delayed diagnosis, and ensures patients feel respected by their health care team.
When a staff is diverse and well-rounded, they are more able to understand the needs of the marginalized groups they serve. For instance, a staff of only straight, cisgender males may not relate well to a transgender, lesbian patient. Employing LGBTQIA+ individuals allows real people to provide input about the needs of a community they belong to, as well as a window into experiences.
Due to the barriers between LGBTQIA+ individuals and health care, many do not know where to begin looking for health care. Offering resources, such as pamphlets, after-visit summary, or informative posters, can help them find what is needed. Resources may include help paying for medications, information about gender-affirming care, LGBTQIA+ counseling, a list of local LGBTQIA+ friendly providers, etc. These resources can make a large difference with accessing health care.
All health care providers should be well-informed on how to provide accessible, high-quality, and relevant care to the LGBTQIA+ community members. Providers must consider marginalized groups in order to serve their community as a whole. Otherwise, large gaps of care will result in the lack of a safe, inclusive environment for members of the community.
Additional sources: One Colorado, Medical Journal of Australia, BMC Medical Education: Springer Nature, The Atlantic, Guttmacher Institute, National Resource Center for Mental Health Promotion and Youth Violence Prevention, and the American Medical Association