Experts Offer Guidance on Improving LGBTQ+ Care

ACR CONVERGENCE 2020—From understanding terminology, to collecting relevant data, to shaping a culture of awareness and inclusivity, clinicians can take many steps to improve the healthcare experience for LGBTQ+ patients, experts said at the ACR Convergence session, Enhance Care for LGTBQ+ Patients.

“All patients have the right to respectful and sensitive nondiscriminatory and effective medical care,” said Jillian Rose, PhD, MPH, LCSW, assistant vice president of community engagement, diversity and research at the Hospital for Special Surgery, New York City. “Transgender patients, especially, may face unique challenges in interactions with physicians and other healthcare professionals. Research shows that increasing healthcare provider education can have positive health outcomes for the LGBTQ+ community.”

Dr. Rose

LGBTQ+ patients have higher rates of depression, suicide, cancer, cardiovascular disease and many other conditions—largely due to a lack of screening and access to healthcare. But, if clinicians can be more intentional about being inclusive and approach care with openness, this can foster a sense of comfort and patient engagement that can lead to better outcomes, Dr. Rose said.

“To care for someone, we have to know who they are, and to really know how they identify,” she said.

Dr. Rose acknowledged that terms can change frequently, but that clinicians don’t have to be perfect in using them to engage more effectively. LGBTQIA+ is a newer umbrella term that includes those who identify as intersex and asexual. Intersex is a general term that captures a variety of conditions in which someone is born with a reproductive or sexual anatomy that doesn’t seem to fit within typical definitions of male and female. Asexual is meant to describe a person who experiences little or no sexual attraction to others. Asexual people may still engage in sexual activity.

Gender identity is a person’s inner sense of who they are, and sexual identity is how people identify their physical and emotional attraction to others.

“It’s important for us not to make assumptions,” Dr. Rose said. “Sometimes, you think someone is one gender identity so they must be attracted to the opposite sex—and that’s a gross mistake.

Crucial in the physician-patient interaction is asking patients who they are, how they identify and the pronouns with which they’d like to be referred.

“People who disclose gender identity and sexual orientation feel safer in discussing high-risk behaviors,” and are more likely to receive relevant screenings and have better engagement with the health system, Dr. Rose said.

‘Research shows that increasing healthcare provider education can have positive health outcomes for the LGBTQ+ community.’ —Jillian Rose, PhD, MPH, LCSW

Dr. Flores