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What Does LGBTQ Health Care Truly Mean?

What does LGBTQ health care really mean? Although understanding the community's specific medical needs is an aspect of it, it also involves a deep cultural competency that builds true doctor-patient trust. Here's what you should know about what it means to truly serve the LGBTQ community's health care needs.

Know How Doctors May Be Perceived

One of the greatest challenges in LGBTQ health care is overcoming patients' hesitancy to see doctors in the first place. In fact, a poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health found that 18 percent of all LGBTQ Americans avoid seeing a doctor out of fear of discrimination. "Overcoming this barrier takes education," said Christopher Swales, MD, a family medicine doctor with Dignity Health Medical Foundation – Woodland and Davis. "It can be uncomfortable for doctors who are not cognizant of the culture to even know what the right questions are." But understanding this and educating yourself can make a significant difference for your patients.

LGBTQ care might not be a medical specialty, but it's a cultural competency that not all doctors have. If you have experience with LGBTQ care, make it known. Include it in your online bio, on your clinic's website, and on your social media accounts. It can also be worthwhile to register as part of GLMA's provider directory. This will allow individuals who are seeking an LGBTQ-friendly physician to find information about your practice.

Taking the time to volunteer at LGBTQ-friendly events can also give you the opportunity to get to know people in your community and build trust. This can help potential patients feel more comfortable with you specifically and the medical community more generally. "I think it's important for physicians to be an active part of the community," said Dr. Swales. "When you're involved in outreach, the community gets to know you better. Patients learn that you're not just the bearer of bad news — you're someone they can connect with, person-to-person."

Be Knowledgeable of Patients' Unique Needs

Another key to providing high-quality health care is being educated about the LGBTQ community's needs. Pre-exposure prophylaxis (PrEP), for example, is a pill that can significantly decrease the risk of getting HIV. "A lot of doctors still feel uncomfortable and are not sure how to prescribe it," Dr. Swales said. "They're not even sure when they should recommend it."

For transgender patients, the first step a provider should take is simply asking what pronouns the patient prefers. Then, don't be afraid to ask relevant questions when taking a health history. And know that as their physician, you'll provide the best care if you work alongside a patient's other specialists. The Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, created by the World Professional Association for Transgender Health, recommends that primary care doctors work hand-in-hand with mental health professionals, endocrinologists (if needed), and other clinicians when treating people who are transgender.

Understand the Psychological Side

Beyond understanding the culture and unique medical needs, you should also be cognizant of the LGBTQ community's unique psychological needs, too. LGBTQ individuals are more likely to have psychological needs. According to a study in the Annual Review of Clinical Psychology, "LGBT youth report elevated rates of emotional distress, symptoms related to mood and anxiety disorders, self-harm, suicidal ideation, and suicidal behavior when compared to heterosexual youth."

Many doctors do not realize that a significant portion of the depression and anxiety that an LGBTQ patient might face is centered on acceptance. "Transgender folks aren't really having a lot of psychological issues based on just their transgender status," Dr. Swales explained. "A significant portion, or most, of that depression and anxiety is coming from their worry about the response from the community and society." Doctors who understand this can make an extra effort to demonstrate their own acceptance and understanding, which can help open the doors of communication and ease anxiety.

Truly meaningful, high-quality LGBTQ health care is achieved by showing respect, understanding medical and psychological needs, and being open to spending extra time educating yourself about the culture. The impact you can have is well worth the effort.

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