“Sarita Wilson is a middle-aged LatinX woman living in rural Michigan. Recently she has been feeling run down and cannot determine a real source for her tiredness. She would like to go to a clinic but in the past, she has felt uncomfortable with providers and is wary of being disrespected because she is a lesbian and has had traumatic experiences with healthcare in the past. She is starting to be concerned and is looking for a local resource.”
Sarita’s story is unfortunately all too common.
People in the LGBTQ community often report that they delay engaging with healthcare for multiple reasons: fear of discrimination, perceived provider bias, and lack of provider knowledge about LGBTQ health, much to their own detriment. Research indicates that LGBTQ people experience health disparities at increased levels compared to their heterosexual counterparts, due in part to minority stressors and implicit bias on the part of healthcare workers. Healthcare professionals’ attitudes may directly influence their patient care. Sarita reported that when visiting a primary care provider in the past for a urinary tract infection, she was told, “Well, that’s what you get for being a lesbian.” Overall, folks in these communities report having poor overall health, increased rates of smoking and alcohol consumption, increased risks for certain cancers and chronic illnesses, higher rates of sexual assault, and multiple behavioral health concerns. Building a practice that strives to support and advocate for folks in these communities is critical to improving their health and well-being.
It is well documented that instituting LGBTQ non-discrimination policies has an additive effect, meaning, the purposeful acknowledgment of people from these communities has a universal benefit and indicates an organization’s commitment to diversity and inclusion. In addition, creating a welcoming environment for LGBTQ people and their families demonstrates an agency’s willingness to support marginalized communities and to advocate for improved healthcare. Creating a culturally safe space for one group, in essence, delivers a message of safety to all.
Creating a welcoming environment for LGBTQ people and their families is relatively easy to institute.
To begin it is important to have leadership buy-in and assurance that LGBTQ nondiscrimination policies and guidelines are in place for all staff. Providing agency wide education and cultural competency training on how to use gender appropriate language and to greet patients and clients with our name and pronoun, and in return, asking for theirs. Changing intake forms to be more inclusive and give people more options to select genders beyond the male/female binary. Providing training on how to collect sexual orientation and gender identity (SOGI) information is invaluable to support all patients. Respectfully and discreetly asking people about their sexual orientation and sexual health communicates an organization’s attention to holistic health.
Making visible changes can be as simple as adding a rainbow pride or transgender pride flag to a website or placing them in the reception or lobby area of the clinic. Having staff wear pronoun or rainbow flag pins is a simple sign that LGBTQ patients and clients will notice immediately. Posting universal non-discrimination policies in the lobby and in treatment rooms is another way to communicate agency commitment to LGBTQ people. Certainly, whenever possible, it is always advisable to hire “out” staff and create internal LGBTQ care navigation committees or advocacy groups.
LGBTQ Community Health Centers across the U.S. have recommended this important transformation and seen dramatic improvement in access to healthcare for the folks under the LGBTQ umbrella. This small network of mostly FQHC’s has led the way by providing patient-centered and community informed care. Small steps will be interpreted as great advances and will go a long way to connecting with LGBTQ individuals and their families in a meaningful way.
By: Cherry Health partner contributor Cecilia (Cec) Hardacker, MSN, RN, CNL, (she/ella) pronouns