June is LGBTQ+ Pride Month. What better time to start our new series on caring for LGBTQ+ patients. As Pride Month draws to a close, let’s focus on some of the ways we can take a competent approach to our LGBTQ+ patients year-round.
You Don’t Have to Know Everything
As an LGBTQ+ physician, I can tell you that this is the first way that healthcare providers get tripped up when caring for LGBTQ+ patients. I’ve seen plenty of colleagues get flustered about discussing specifics of gender identity and sexuality, some to the point of figurative paralysis. This can result in awkward interactions and get in the way of forming a good rapport with your patients. The best approach is to borrow one of the classic strategies of cultural competency: let your patients define themselves. If you want to know medically-relevant information regarding to their gender and sexuality, ask. If you don’t understand what one of their identities or identifiers means, again, respectfully ask. Patients do not expect you to know everything about their gender expression or sexual identity – these are highly personal aspects of who they are and will vary from patient to patient. They will be happy that you took the time to understand them better as an individual rather than doing the following…
Avoid Assumptions
This may sound like the most basic tip, but it’s always important to check your assumptions before patient interactions. This is especially true when caring for LGBTQ+ patients. I would like to reiterate, no two patients are alike, and each patient’s personal journey when it comes their gender identity or sexuality will vary. Making assumptions may make it seem like you are resorting to stereotypes rather than seeing your patient for who they are. For example, patients may identify as transgender, but have no desire to medically transition. Patients may identify as “straight” but still have romantic and sexual relationships with those of the same sex. Taking the time to get to know your patients and check your assumptions at the door will ensure that you’re getting all of the right information, and that your patients feel comfortable with you.
Look Beyond the Textbook
Another way to gain a better understanding of your patients is to update your understanding of current issues affecting the LGBTQ+ community, medical or otherwise. Much of the way LGBTQ+ patients are presented in medical education and literature relies on automatic and sometimes outdated associations that lack the nuance we should use in clinical practice. For instance, we know that men who have sex with men are at a higher risk than the general population for contracting HIV, but are we having conversations with our patients about Pre-Exposure Prophylaxis (PrEP)? We know the potential side effects of the medical transition process of our transgender patients, but do we recognize the rampant rates of violence against transgender people? Do we recognize that stress caused by that kind of climate can impact the progression of our patients’ dermatologic disease? While no single patient encounter can address all the disparities and struggles our LGBTQ+ patients face, keeping current with the literature will make it easier to take a more competent and comprehensive approach.
Implement Inclusivity
The easiest way to make a commitment to competent care for your LGBTQ+ patients is to implement inclusivity into the very workings or your practice or department. If inclusivity and engagement of LGBTQ+ patients are part of your everyday process, you won’t have to think twice about them. This can take the form of establishing a nondiscrimination or inclusivity policy in your workplace, holding an LGBTQ+ competency training for the providers and staff on your team, or starting a practice or department-wide outreach program to specifically engage LGBTQ+ patients. Inclusivity can also take the shape of small changes that will help your patients feel immensely more comfortable, like asking about gender and sexuality on your intake forms. Furthermore, allowing patients to fill in their gender identifiers, preferred gender pronouns and preferred name rather than just providing a few options or assuming based on their ID will show your patients that you care about their identities from the very beginning. Even small efforts like these can go a long way to help your patients feel seen and strengthen the doctor-patient relationship.
Stay tuned for another delivery of my LGBTQ+ Health Series coming up next month.
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