Some healthcare organizations aim to be more inclusive of LGBTQ patients
RESEARCH SHOWS LGBTQ individuals are likely to report such poor health outcomes as obesity and mood disorders, and yet healthcare organizations still don’t widely offer services specific to their needs.
Furthermore, LGBTQ patients report facing discrimination when seeking healthcare. Some providers deny care to transgender individuals, and physicians and nurses have a history of asking inappropriate questions or making wrong assumptions about LGBTQ persons’ healthcare needs.
But a growing number of healthcare institutions are bucking the status quo and making a concentrated effort to improve LGBTQ care.
Among them is Northwell Health in New York. Four years ago, Northwell established a center for transgender care and recently opened a space to offer those services at Long Island Jewish Medical Center. The center cost $850,000 to build and offers services in various specialties including endocrinology, plastic surgery, adolescent medicine and OB-GYN. The center is also staffed by a primary-care doctor, psychiatrist, psychologist, nurse practitioner and two trans-health navigators.
“We were never able to have comprehensive services all in one location,” said Dr. David Rosenthal, the center’s medical director. “We determined there was a need for a dedicated space.”
University of Oklahoma College of Medicine recently developed a course that trains future physicians on how to appropriately interact with LGBTQ patients in a clinic setting.
Riley Darby-McClure, a medical student at the University of Oklahoma, approached professors there last year about establishing the course. Darby-McClure is transgender and was concerned LGBTQ care was only briefly discussed during the first two years of medical school.
Although more schools have incorporated LGBTQ education in recent years, schools don’t spend much time on the topic, said Dr. Shauna Lawlis, an assistant professor at the University of Oklahoma College of Medicine who treats transgender adolescents in her practice. A 2011 study found that at 132 U.S. and Canadian medical schools students on average spent 6.5 hours on LGBTQ content during their training.
Lawlis, Darby-McClure and another faculty member put together the program, which includes a one-hour didactic session, a few hours in a clinic interacting with LGBTQ patients and discussion afterward. In all, the program is about four to five hours long. Lawlis said lectures on LBGTQ care have also been added to the curriculum.
The didactic session involves discussing the health disparities the LGBTQ population experiences; the historic lack of knowledge from providers on LGBTQ care; the difference between sex and gender; and how to tactfully ask about sexual behavior, sexual orientation and hormone therapy.
The clinical portion involves LGBTQ volunteers scripting different scenarios that may come up in a visit, such as getting a prescription for pre-exposure prophylaxis for HIV or a transgender individual asking about fertility.
In a simulated clinical setting, the student sits down with the volunteer to ask and answer questions pertinent to the scenario. Afterward, students discuss the experience in class, such as what they learned and what was challenging. The pilot, offered in April 2019, was well-received by the roughly 30 participating students, Darby-McClure said.
This academic year, the program received a grant to continue the program for all second-year medical students. The $5,000 grant also allowed the school to pay volunteers. Lawlis said it’s unclear if another grant will be offered to continue the program, but she’s interested in studying its impact on the more than 150 participating students.
Darby-McClure said it would be wonderful if the school expanded the program to other underrepresented populations. “That will contribute to more realistic educational experiences for students that really need to be exposed to different cultures.”