Effective and compassionate healthcare practitioners are familiar with and understand the issues facing their patients, especially those from vulnerable populations. One such population is the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community, which may face many social challenges that affect their ability to receive timely and appropriate care.
Jason Addison, MD, service chief of the Adult Crisis Stabilization Unit, says that a patient may not immediately identify themselves as a member of the LGBTQIA+ community, so it is important to show patients that they are in a safe space. “While we are assessing the needs of our patients, they also are assessing us,” he says.
“They may be looking to see if they can trust us, if we are respectful, and if we have appropriate boundaries. We must reflect our values and be a welcoming, supportive environment where patients can trust us to talk about all the issues in their life.”
To ensure your practice is a safe space, Afifa Adiba, MD, service chief of the Adolescent Mood Disorders Unit at Sheppard Pratt, says all healthcare providers must expand their understanding of the challenges facing this community. This may mean recognizing that a person who is gay or has a gender identity that differs from what they were assigned at birth may face additional struggles that may be proximate contributors to their anxiety and depression. For example, family rejection may have caused them to be homeless. Bullying at school, in the workplace, or online may make them feel unsafe. In some localities, being LGBTQIA+ can put one at risk of being a victim of a hate crime.
“We must prioritize cultural competence,” Dr. Adiba says. “Doing two or three trainings online may make you culturally literate, but you must acquire competence on your own through self-reflection and understanding.”
Take time to improve your interactions with members of the LGBTQIA+ community. Take advantage of additional training and best practices through Sheppard Pratt’s free CMEs.
Do not assume a patient’s gender identity or sexual orientation.
There is no scientific basis for “conversion” or “reparative” therapy to change a person’s sexual orientation. Rather, these rely on shaming and other unhealthy tactics that may increase anxiety, de
Refer to the patient by their preferred name and pronouns and adjust, if necessary, when interacting with others. (Some patients will not be “out” to their family, school leaders, etc.)
Helping family members accept their LGBTQIA+ relations can lessen stressors that lead to suicidality.
Be an ally to patients and help them see their identity/orientation as a source of pride and resilience.