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LQBTQIA Medicine June 23, 2023

3 Ways to Provide Culturally Affirming Care to LGBTQ Patients

Lesbian, gay, bisexual, transgender or queer/questioning patients have historically experienced discriminatory barriers to care, both personal (e.g., internalized stigma) and structural (e.g., lack of provider training). A survey by the Howard T.H. Chan School of Public Health found that nearly one in five LGBTQ adults have avoided medical care for fear of discrimination. Ensuring that your clinical setting and approach are welcoming to this population is critical to helping decrease LGBTQ health disparities and improve patient outcomes.

Stethoscope and rainbow LGBTQ Pride flag

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There are several ways to create a safer and more affirming environment for LGBTQ patients. Following are three recommendations, with accompanying education from trusted organizations such as Howard Brown Health and SAGECare.

  1. Use affirming and respectful terminology

    Using the correct language to address clients and peers is an obvious way to show them you care. But language is ever evolving. It’s important to stay up to date on respectful terminology—including what terms to avoid—and adapt your practice accordingly. As explained by SAGECare in this Hearing and Using LGBT-Affirming Language module, whether a term is positive or negative is often determined by the context within which it’s used. For example, the word “queer” has a history of being used pejoratively, but it has been since been reclaimed. Older LGBT older adults, however, may still find the word triggering. To understand your patients’ preferences, listen to the words they initially use to describe themselves and their relationships and reflect that language back to them.
    Learn more: Defining LGBTQ Terms for Physicians

  2. Think beyond the binary

    Despite the varieties of gender identity and expression that have existed for centuries, society often takes a binary view of sex and gender. As stated in the Howard Brown Health module Creating Trans-Affiming Spaces: Using Gender-Appropriate Language, “Those who fit into a binary are normalized and privileged while those who challenge these standards are punished.” It’s important that health professionals recognize gender as a spectrum. Simple actions you can take in your practice to move beyond binaries include offering gender-neutral bathrooms and using inclusive language on intake forms—for example, “preferred name” and “preferred pronouns.”
    Learn more: LGBT Inclusion: A SAGECare Podcast

  3. Stay up to date on LGBTQ health issues and disparities

    LGBTQ patients face unique health risks, both mental and physical. This includes higher rates of chronic disease, such as cardiovascular disease and diabetes; higher rates of anxiety, depression and suicide; and evidence of higher rates of cancer. LGBTQ patients who are also members of minority populations confront even greater health disparities. Furthermore, LGBTQ youth are among those most vulnerable to human trafficking. By being aware of these specific health care risks, you’ll be more likely to look out for them and offer the appropriate support and resources.
    Learn more: LGBTQ Essentials: Foundations of Care

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Everyone deserves quality health care regardless of gender or sexual orientation. It’s imperative that all health care professionals be knowledgeable and culturally competent in LGBTQ health. Remember that educating yourself is an ongoing process and will help you provide effective health care for all your patients.

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