Until 1973, homosexuality was listed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders. Although the evolution of our society has led to some understanding of the importance of protecting people from discrimination in healthcare settings, some clinicians still harbour harmful anti-LGBT attitudes. Healthcare professionals take an oath to “do no harm” when treating patients. If medics do not uphold this rule, how are they ensuring that absolutely no harm is being done? Creating an affirming and inclusive environment for the LGBTQ+ community requires a combination of understanding members as their own population whilst treating every LGBTQ+ person as a unique individual. This article highlights some strategies that current (and prospective) healthcare professionals can use to ensure that.
Practical Thinking
Many LGBTQ+ people in North America do not have health insurance, with 11% not understanding its coverage.[1][2] In such cases, it is vital to provide the LGBTQ+ community with education on health insurance, while making them feel as comfortable as possible. We must help LQBTQ+ individuals enroll for care and deal with healthcare costs. This is an essential step to solving healthcare inequality for the LGBTQ+ community.
The LGBTQ+ community may be reluctant to open up about the true nature of their health issues due to a lack of trust. It is crucial to put yourself in their shoes to understand why the trust issues might exist. A 2018 survey conducted by the Centre for American Progress found that, “8% [of LGBTQ+ patients] said that the doctor refused consultation because of their actual or perceived sexual orientation. 6% said that doctors denied the LGBTQ+ healthcare linked to their actual or perceived sexual orientation, and an unfortunate 7% said that they experienced unwanted physical contact from a doctor or other healthcare provider.” In the same study, among transgender people who had visited a doctor, 29% said that the doctor refused consultation due to their sexual orientation, 12% said that healthcare linked to their sexual orientation was denied, and 29% said that they experienced nonconsensual physical contact.[2] Happenings like these have caused many LGBTQ+ people to lose faith in the medical system or doubt its ethical standards.
Communication Basics
Using correct vocabulary and tone of voice is fundamental to developing a good rapport with LGBTQ+ patients. We should avoid assumptions about an individual’s gender identity and sexual orientation at the most basic level. In a 2018 survey, 9% of LGBTQ+ and 21% of all transgender patients reported that healthcare providers used harsh and abusive language. We, as the future generation, need to pay extra attention to address individuals and their partners as respectfully as possible, to stop this. If somebody calls themselves “gay,” we must not use the term “homosexual,” which is no longer politically correct. If a woman refers to her “wife,” we must not address her as a “friend.” Instead of asking, “Do you have a boyfriend/girlfriend?” it is more inclusive to ask, , “Are you in a relationship?” Using open-ended questions will allow clinicians to initiate discussions about relationships and sexual behavior without assuming heterosexuality.[4]
Pronouns and Preferred Names
In a 2018 survey, 23% of transgender people said that the healthcare provider intentionally misgendered them or used the wrong name. It is impractical to guess someone’s gender identity based on their name, looks, or sound. Therefore, when addressing somebody for the first time, instead of asking, “How may I help you, sir?” we should avoid using masculine or feminine specific terms, and instead ask, “How may I help you?” When unsure of what name to use when addressing patients, it is helpful to make eye contact or lightly tap on their shoulders. Alternatively, if you want to be straightforward, a simple “I would like to be respectful. How would you like to be addressed, and what pronouns do you prefer I use to refer to you?” is perfect.[2]
Maintaining a Non-Judgemental Attitude
It is fundamental to avoid disapproval or surprise when you discover a patient’s gender identity or sexual orientation. We should aim to constantly be aware of our facial expressions and body language to ensure that we do not send off unintended messages. In this way, we can keep an open mind while helping LGBTQ+ patients feel a sense of safety.[1][2]
Accepting Your Mistakes
It is not always possible to avoid making errors, and as humans, it is natural to make mistakes. Apologizing when you have used the wrong pronoun, name, or terminology, and moreover, using correct terms in the future, will show that you meant no disrespect. This helps when trying to initiate discussions and build trust.[3]
Healthcare is one of the most basic human rights and something we should never be deprived of. I felt the need to familiarise people with these strategies because I firmly believe that every individual in our community should have their rights protected. The success of healthcare organizations of all types – ranging from academic medical centers to community hospitals – depends on providing care to patients that optimizes quality and clinical effectiveness. As I’m sure clinians do with all patient populations, they should also try to understand the cultural context of the lives of LGBTQ+ patients. Healthcare facilities should try to make amendments to their policies to make the environment more inclusive. This could also give clinicians the opportunity to reflect upon their attitudes and ensure that they provide affirmative care to the LGBTQ+ community. By doing so, clinicians can ensure that all of their patients – especially the LGBTQ+ patients, are getting the highest possible level of healthcare.
References:
- Ard, K., Makadon, H. Improving The Healthcare of Lesbian, Gay, Bisexual and Transgender People. The Fenway Institute. Retrieved 8 June 2020. [Online] Available from: <https://www.lgbthealtheducation.org/wp-content/uploads/Improving-the-Health-of-LGBT-People.pdf>
- Mirza, S., Rooney, C. (18 January 2018). Discrimination Prevents LGBTQ People From Accessing Health Care. Center for American Progress. Retrieved 8 June 2020. [Online] Available from: <https://www.americanprogress.org/issues/lgbtq-rights/news/2018/01/18/445130/discrimination-prevents-lgbtq-people-accessing-health-care/>
- Powell, A. (23 March 2018). The Problems With LGBTQ Health Care. The Harvard Gazette – Health & Medicine. Retrieved 8 June 2020. [Online] Available from: <https://news.harvard.edu/gazette/story/2018/03/health-care-providers-need-better-understanding-of-lgbtq-patients-harvard-forum-says/>
- Cigna. (February 2017). LGBT Health Disparities. Cigna Individuals and Families. Retrieved 8 June 2020. [Online] Available from: <https://www.cigna.com/individuals-families/health-wellness/lgbt-disparities>
Written By: Zuairia Shahrin
Edited By: Amir Ali Adel
Campus UNICEF 