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Diversity in Medicine: Creating An LGBTQ Inclusive Environment

A quick Google search of the words “being gay in medicine” reveals a plethora of forums, op-eds, and blog articles regarding how identifying as LGBTQ will affect a person’s chances of getting accepted to medical education programs, whether or not patients will deny care from an openly queer provider, and just general searches for other future providers in the LGBTQ community.

As a lesbian in PA school, I have considered all of these issues for myself and have intentionally withheld this information about myself and my partner in conversation for fear that I might be treated differently by my classmates, instructors, or preceptors. I have also been on the receiving end of judgement and criticism from healthcare providers, and I know firsthand that this phenomenon is not uncommon within the LGBTQ community. These kinds of attitudes may seem antiquated in 2018, but they can create an atmosphere of distrust even among individuals who love medicine and aspire to practice it.

Now, after completing my didactic year of physician assistant school and developing close relationships with classmates and instructors alike, I am elated to say that none of my fears came to fruition and I have found a platform within my identity to share my experiences with others through social media and my blog, coutureinclinic.com. The outpouring of support has been more meaningful than I could have imagined.

Almost every day I am reminded of the importance of LGBTQ representation in the medical field through messages I receive telling me that sharing my experiences has given someone “the courage to come out to their classmates without fear”, or that someone was able to show their pre-med daughter that “she will be accepted for who she is by her patients and coworkers.” Sometimes I will receive a message simply saying, “I have never even met another lesbian woman in this field!”

Because of this positive feedback and encouragement from others, I am so proud to be a voice and kindred spirit to others in my position, and celebrate the diversity in medicine that helps us serve ALL of our patients with compassion and without judgement.

It is inevitable that all providers will treat patients who identify as LGBTQ and it is critical that we make those experiences positive ones, as this community faces major health disparities. According to the National Health Statistics Report conducted by the Centers for Disease Control, 30% of transgender youth have attempted or completed suicide, gay men are more likely to die from easily treated prostate cancers because they avoid seeking medical care, lesbian women do not get screened for cervical cancer at the same rates as their heterosexual peers, and LGBTQ individuals are almost 3 times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder.

While these statistics seem daunting, there are very simple things that we as providers can do to create an inclusive, welcoming, and judgement-free environment that can ease our patients fears and establish good rapport!

Outward displays of allyship

I cannot tell you how relieving it is to see a school faculty member or provider at my University who has a “SafeZone” sticker displayed outside their office door. SafeZone is an incredible organization that sponsors both in-person training sessions and online personal education materials for powerful, effective, LGBTQ awareness and ally training. They also offer free stickers and pins that you can put on your office door or Medelita white coat showing that you are a trained ally to the community. This sets a tone of inclusion and compassion right off the bat! A simple sticker can truly have a huge impact on a patient’s impression of you.

Inclusive intake forms

Another very simple step to take is to include a “preferred name” on your intake forms that all patients must fill out. For medical record reasons, it is important to have a patient’s legal name but many patients (even non-LGBTQ patients!) prefer a different name which you can see and use right away without any awkward questioning.

To take this a step further, include a “preferred pronoun” line on the form. When this became standard at my university, several people expressed relief that they could forego lengthy and unnecessary conversations about their name and pronouns with their providers and could simply be addressed as they identify. If you cannot change your intake forms, simply ask your patients, “What is your preferred name and pronoun? I prefer she/her/hers.” It may sound unusual, but it’s an easy habit to get into and patients will be appreciative!

Direct communication is key

When taking a patient’s sexual history, an important part of a comprehensive exam, ask questions straightforwardly and simply. For example, “Do you have sex with men, women, or both?” should be as easy for you to say as “Do you use sunscreen daily?” Do not be afraid to divulge into the details! It is important for you as a provider to know how to counsel your patients on safe sex, regardless of their partners.

It is pretty standard to counsel heterosexual patients on condom use and birth control, but do you know how to counsel a lesbian or bisexual patient on how to be safe? This is another topic that is covered in SafeZone (or most any other professional education program) and it’s okay to admit what you don’t know! LGBTQ health is rarely ever taught in medical school or nursing school and unfortunately, it becomes the responsibility of the provider to educate themselves in order to best serve their patients.

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As we continue to acknowledge and celebrate the wonderful diversity that exists amongst our patients (and providers!) keep in mind that sexual orientation/gender identity is just one of the many amazing attributes of a person! My sexuality accounts for one of the thousands of things that people know about me, and it's not all that I am. I am also multiracial, a black belt in karate, a terrible cook, a dog lover, and so many other things that make me a unique individual.

When (not if!) you encounter an LGBTQ patient, remember that it’s just one part of their identity, and it’s our jobs to acknowledge that with acceptance and compassion, and find out what else makes that person special! By honoring the diversity in all of us, we create a happier, healthier society!


About the author:

Asia Sullivan is a second year physician assistant and public health master’s degree student at the University of Alabama at Birmingham. She is passionate about public health and reducing health disparities and plans to work clinically and conduct research. Outside of school, she enjoys yoga, her two dogs, and spending time with her partner of almost 7 years. Follow Asia on Instagram and visit her blog at CoutureinClinic.com.