Guidelines for Care of Lesbian, Gay, Bisexual and Transgender Patients
Research has demonstrated LGBT (lesbian, gay,
bisexual, & transgender)
populations have the same basic health needs as the general
population; however, they also experience a discrepancy in health care
due to barriers related to sexual orientation and/or gender identity
or expression. Many LGBT individuals receive less than adequate health
care or avoid it all together because of homophobia, bi-phobia,
transphobia, and discrimination by health care providers as well as
the health care system. Unfortunately, homophobia is a reality many
LGBT individuals face. A 1998 survey of nursing students showed that
8-12% "despised" LGBT people, 5-12% found them "disgusting,"and 40-43%
thought LGBT people should keep their sexuality private.
In order to combat stereotypes and attitudes like those in the study
above, it is crucial for health care providers to take positive steps
to support the health of their LGBT clients. This may be done by
taking a critical look at their practices and policies as well as
staff to improve access to quality health care for LGBT people.
This article focuses on three specific areas relating to health care
and LGBT individuals.
- Creating a welcoming clinical environment for LGBT patients
- Caring for lesbian and bisexual women: Additional considerations for clinicians
- Caring for gay and bisexual men: Additional considerations for clinicians
Creating a Welcoming Clinical Environment for LGBT Patients
This section discusses ways to improve the office environment to be more welcoming and accepting of LGBT clients. This includes things as simple as changing intake and health history forms to include inclusive language or training staff to be more knowledgeable and sensitive to LGBT clients. This section also discusses more comprehensive changes which need to take place such as including discussions with LGBT clients surrounding specific issues such as homophobia which contribute to depression, stress and anxiety in LGBT people.
Caring for Lesbian and Bisexual Women: Additional Considerations for Clinicians
The health care needs of lesbians and bisexual women are similar to
those of all women. With this said, there are additional risk factors
and obstacles which may impact their health and well being. Coming out
safely to a health care provider is significant as it will increase
the quality of health care and reduce the associated risk factors for
health problems which may result by not coming out. Because of this,
it is extremely important health care professionals provide a safe and
caring environment for all women to converse about health-related
behaviors, including sexual histories and practices.
Patients are more likely to be more open regarding health and well
being if they feel comfortable and safe in their healthcare setting.
In general, lesbians and bisexual women are healthy and well-adjusted
and it is important to avoid further stigmatizing lesbians and
bisexual women as inherently sicker or more "difficult" than
heterosexual women.
Caring for Gay and Bisexual men: Additional Considerations for Clinicians
Gay and bisexual men's health care needs are comparable to the needs
of all men; nonetheless, there are further risk factors and obstacles
that have the potential to impact their health and well being. If
health care providers are made aware a male patient is gay, bisexual,
or has sex with men, a more comprehensive approach to care may be
provided such as screening for potential risk factors.
Furthermore, gay and bisexual men may deliberately avoid medical care
because of fear of discrimination. As a result, it is crucial health
care professionals provide a safe and positive environment for gay and
bisexual men to self-identify and talk about health-related issues
such as sexual history and behaviours. Instituting a gay and
bisexual-friendly environment will encourage gay and bisexual men to
actively seek out care.