There's a lot of information for LGBT patients seeking medical help, but very little help for medical practitioners. LGBT folk often rely on word-of-mouth referrals or the knowledge that a particular doctor is lesbian or a nurse is gay. But that needn't be the case.
There are things you can do to help your provider create an environment that is safe and welcoming.
- Encourage the provider to participate in provider referral programs through LGBT organizations or to advertise his or her practice in LGBT media
- Provide posters or pamphlets with gay-friendly or gay positive messages for the office, clinic, or hospital
- Acknowledge relevant days of observance in your practice, such as World AIDS Day or gay pride.
- Suggest that the provider subscribe to gay-oriented news or entertainment magazines (including those that focus on LGBT people of color) in addition to those with a general appeal.
- Ask the provider to post non-discrimination statements inclusive of sexual orientation and gender identity and expression.
In addition to the environment, there are other areas where adopting LGBT friendly practices will make your provider more LGBT comfortable. You can also suggest that he or she...
Provide forms written with appropriate language
Such forms should...
- Use the term "relationship status" instead of "marital status,"
- Include options like "partnered."
- Use terms like "partner," in addition to "spouse" and/or "husband/wife" when asking for information about a patient's significant other
- Offer the option of identifying with a particular sexual orientation or providing further explanation.
Conduct Sensitive Interviews
Your provider should approach an interview with empathy, open-mindedness, and without rendering judgment. Talking about issues related to patient sexuality is not easy; the provider needs to become comfortable with raising and discussing such topics. During such an interview, the provider should...
- Use gender-neutral language when inquiring about sexual partners or significant others
- State that taking a sexual history is routine for his or her practice.
- Avoid inquiring about sexual orientation and focus on sexual behavior.
- Assess knowledge of the risk of sexually transmitted infections in relation to sexual
behavior early on. (Some well-informed LGBT folk may resent a discussion of HIV risk; for example, assuming a clinician is equating homosexuality with HIV.)
- Clarify terms or behaviors with which you are unfamiliar.
- Respect your desire to withhold answers to sensitive questions and offer to discuss the issue at a later time.
Provide Sensitivity Training for Staff
Administrative, nursing, and clinical staff education is critical to creating and maintaining friendly environments. A good staff-training program should include topics like these:
- Use of appropriate language when addressing or referring to patients and/or their significant others
- Basic familiarity with important LGBT health issues (e.g., substance abuse, partner violence, HIV, STDs, depression, discrimination in social accommodations and the workplace)
- Indications and mechanisms for referral to gay-identified or gay-friendly providers.
- Resource lists and guidelines for patient interactions (these can reduce possible staff anxiety in dealing with MSM and/or gay-identified patients.)
Provide Confidentiality Statements
Providers should offer a written confidentiality statement that encourages you to disclose information pertinent to sexual health. The policy should spell out:
- The information covered
- Who has access to the medical record
- How test results remain confidential
- How information is shared with insurance companies
- Instances when maintaining confidentiality is not possible
And the provider should display the confidentiality statement prominently and provide it in writing to every patient. All staff members should agree to the statement in writing.
Provide Key Resources and Relationships
An individual clinician or practice cannot meet every need of LGBT patients. Developing a list of resources available in the local community facilitates comprehensive and quality care for all patients. These can include 3:
- Local community centers
- Counseling services including support groups, mental health services, and health education
- Legal resources
- Identification of subspecialists and other providers in your community who are L,G,B, or T or LGBT friendly.
