CONCLUSION
Providing high-quality, culturally competent care to all patients involves understanding the cultural contexts of each individual. In the case of LGBTQ+ patients, it is important to educate oneself on issues related to sexual orientation and gender identity in order to address and understand the spectrum of these patients’ health concerns. This may include addressing any health risks or disparities, with careful attention to any behavioral health needs and transgender care.
When considering best practices for providing culturally competent care, healthcare professionals should carefully evaluate their practice environment; examine, advocate for, and modify practice policies when needed; take detailed and nonjudgmental histories; educate themselves and/or update their knowledge on the health issues of LGBTQ patients; and reflect on any personal attitudes or bias that may prevent them from providing the highest level of care to their patients. By taking these positive steps, healthcare providers can ensure that all patients they care for achieve the best possible health outcomes.
RESOURCES
GLMA: Health Professionals Advancing LGBTQ Equality
Lesbian, gay, bisexual, and transgender health (Centers for Disease Control and Prevention)
LGBTQ healthcare laws and policies map
Mayor’s Office of Lesbian, Gay, Bisexual, Transgender and Questioning Affairs (Washington, DC)
National Center for Transgender Equality
National Coalition for LGBTQ Health
National LGBT Health Education Center (Fenway Institute)
Washington, DC, advance directive form (National Hospice and Palliative Care Organization)
WPATH (World Professional Association for Transgender Health)
REFERENCES
NOTE: Complete URLs for references retrieved from online sources are provided in the PDF of this course.
American Cancer Society (ACS). (2021). Cancer facts for lesbian and bisexual women. https://www.ca
American Nurses Association (ANA). (2018). Position statement: Nursing advocacy for LGBTQ+ populations. https://www.nursingworld.org
American Occupational Therapy Association (AOTA). (2021). Diversity, equity, and inclusion strategic plan. https://www.aota.org
American Physical Therapy Association (APTA). (2019). Nondiscrimination HOD Y06‐19‐43‐52 policy. https://www.apta.org
American Psychological Association (APA). (2022). A guide to sexual orientation and gender diversity terms. https://www.apa.org
Annie E. Casey Foundation (AECF). (2021). Definitions of common LGBTQ concepts and terms. https://www.aecf.org
Brown A. (2022). About 5% of young adults in the U.S. say their gender is different from their sex assigned at birth. Pew Research Center. https://www.pewresearch.org
Byne W, Karasic DH, Coleman E, Eyler AE, Kidd JD, Meyer-Bahlburg HFL, Pleak RR, & Pula J. (2020). Gender dysphoria in adults: An overview and primer for psychiatrists. Focus, 18(3), 336–50. https://focus.psychiatryonline.org/doi/epdf/10.1176/appi.focus.18304
Caughey AB, Krist AH, Wolff TA, et al. (2021). USPSTF approach to addressing sex and gender when making recommendations for clinical preventive services. JAMA, 326(19), 1953–61. doi:10.1001/jama.2021.15731
Centers for Disease Control and Prevention (CDC). (2022a). STD facts: What gay, bisexual and other men who have sex with men need to know about sexually transmitted diseases. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (2022b). Gay and bisexual men’s health. For your health: Recommendations for a healthier you. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (2022c). HIV prevention and care for transgender people. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (2022d). LGBTQ+ people experience a health burden from commercial tobacco. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (2021). Transgender and diverse persons. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (2020). Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020, 31. https://www.cdc.gov
Centers for Medicare and Medicaid Services (CMS). (2010). Medicare and Medicaid programs: Changes to the hospital and critical access hospital conditions of participation to ensure visitation rights for all patients. https://www.federalregister.gov
Cleveland Clinic. (2022). Intersex. https://my.clevelandclinic.org
Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, et al. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(supp 1), S1–S259. doi:10.1080/26895269.2022.2100644
Cordero C & Tschurtz B. (2022). Meeting the needs of the LGBTQ+ community—Then and now. The Joint Commission. https://www.jointcommission.org
Council of the District of Columbia. (2022). Code of the District of Columbia. §16–4901. Authorization for medical consent for a minor by an adult caregiver. https://code.dccouncil.gov
Delphin-Rittmon ME. (2022). LGBTQI+ youth—Like all Americans, they deserve evidence-based care. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov
Domogauer J, Cantor T, Quinn G, & Stasenko M. (2022). Disparities in cancer screenings for sexual and gender minorities. Current Problems in Cancer, 46(5), 1–11. https://doi.org/10.1016/j.currproblcancer.2022.100858
Eder M, Henninger M, Durbin S, Iacocca MO, Martin A, Gottlieb LM, & Lin JS. (2021). Screening and interventions for social risk factors: a technical brief to support the U.S. preventive services task force. AHRQ Publication No. 20-05267-EF-1. Agency for Healthcare Research and Quality. https://www.uspreventiveservicestaskforce.org
Garrett MB. (2022). Optimizing case management services for LGBTQ individuals. CMSAtoday. https://cmsatoday.com
GLMA. (n.d.). Guidelines for care of lesbian, gay, bisexual, and transgender patients. http://glma.org
GLAAD. (n.d.). GLAAD media reference guide (11th ed.). https://www.glaad.org
Goldsmith L & Bell ML. (2022). Queering environmental justice: Unequal environmental health burden on the LGBTQ+ community. American Journal of Public Health, 112(1), 79–87.
Grasso C, Goldhanner H, Thompson J, & Keuroghlian AS. (2021). Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. Journal of the American Informatics Association, 28(11), 2531–5.
Hao J, Beld M, Khoddam-Khorasani L, Flentje A, Kersey E, Mousseau H, Frank J, et al. (2021). Comparing substance use and mental health among sexual and gender minority and heterosexual cisgender youth experiencing homelessness. PLoS One, 16(3), 1–13. doi:10.1371/journal.pone.0248077. PMID: 33705446
Hoy-Ellis CP. (2021). Minority stress and mental health: A review of the literature. Journal of Homosexuality, 68(14), 2417–29. https://doi.org/10.1002/ajcp.12455
Human Rights Campaign (HRC). (2020). HRC’s brief guide to getting transgender coverage right. https://www.hrc.org
Institute of Medicine (IOM) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. National Academies Press. https://www.ncbi.nlm.nih.gov
Lesbian, Gay, Bisexual, Transgender, Queer Plus (LGBTQ+) Resource Center. (n.d.). Gender pronouns. University of Wisconsin, Milwaukee. https://uwm.edu
McHenry SE. (2022). “Gay is good”: History of homosexuality in the DSM and modern psychiatry. American Journal of Psychiatry Resident’s Journal, 18(1), 4–5.
Medina C & Mahowald L. (2022). Collecting data about LGBTQI+ and other sexual and gender diverse communities: Best practices and key considerations. Center for American Progress. https://www.americanprogress.org
Medina C & Mahowald L. (2020). Repealing the Affordable Care Act would have devastating impacts on LGBTQ people. Center for American Progress. https://www.americanprogress.org
Medina-Martínez J, Saus-Ortega C, Sánchez-Lorente MM, Sosa-Palanca EM, García-Martínez P, & Mármol-López MI. (2021). Health inequities in LGBT people and nursing interventions to reduce them: A systematic review. International Journal of Environmental Research and Public Health, 18(22), 1–16. doi:10.3390/ijerph182211801
National Alliance on Mental Illness (NAMI). (2022). LGBTQI. https://www.nami.org
National Center for Cultural Competence (NCCC). (n.d.). Conscious & unconscious biases in health care. https://nccc.georgetown.edu
National LGBTQIA+ Health Education Center (HEC). (2022). Ready, set, go! A guide for collecting data on sexual presentation and gender identity. https://www.lgbtqiahealtheducation.org
National LGBTQIA+ Health Education Center (HEC). (2021). Ten strategies for creating inclusive health care environments for LGBTQIA+ people. https://www.lgbtqiahealtheducation.org
Ni P. (2020). 10 signs of internalized homophobia and gaslighting. Psychology Today. https://www.psychologytoday.com
Office of Disease Prevention and Health Promotion (ODPHP). (n.d.). Healthy people 2030: Lesbian, gay, bisexual, and transgender health. https://health.gov
Office on Women’s Health. (2020). Recognizing the needs of lesbian, bisexual, and transgender women. https://www.womenshealth.gov
Open Access Government. (2020). Lesbian and bisexual women more likely to have substance addictions. https://www.openaccessgovernment.org
PFLAG. (2022). PFLAG national glossary of terms. https://pflag.org
Planned Parenthood. (2022). What’s intersex? https://www.plannedparenthood.org
Powell L. (2021). We are here: LGBTQ+ adult population in United States reaches at least 20 million, according to Human Rights Campaign Foundation Report. Human Rights Campaign. https://www.hrc.org
Researching for LGBTQ2S+ Health. (n.d.). Two-spirit community. https://lgbtqhealth.ca
Reynolds CM. (2020). Safe healthcare for all patients: Voices of the LGBTQ community seeking safe and inclusive care. Patient Safety, 2(1), 64–71. https://patientsafetyj.com
The Joint Commission (TJC). (2019). Speak up for your rights. https://www.jointcommission.org
The Joint Commission (TJC). (2011). Advancing effective communication, cultural competence, and patient- and family-centered care for the lesbian, gay, bisexual, and transgender (LGBT) community: A field guide. https://www.jointcommission.org
The Trevor Project. (2022). Substance use and suicide risk among LGBTQ youth. https://www.thetrevorproject.org
The Trevor Project. (2021). New research underscores mental health disparities faced by diverse LGBTQ youth amid COVID-19 & beyond. https://www.thetrevorproject.org
The Trevor Project. (2020). Substance use disparities by sexual identities. https://www.thetrevorproject.org
University of Wisconsin Public Health Institute. (2020). Cultural competence training for health care professionals. https://www.countyhealthrankings.org
WebMD. (2020). Lesbian health. https://www.webmd.com