In 2017, data from a national Center for American Progress (CAP) survey showed that 14 percent of LGBTQ (lesbian, gay, bisexual, transgender, and queer) patients had experienced discrimination based on their sexual orientation or gender identity, and that they had avoided or delayed crucial medical assistance because of this type of discrimination from a healthcare provider or member of their staff. LGBTQ patients who have experienced some type of discrimination in a healthcare setting are more likely to then have trouble finding alternative services in the event that they were turned away.
With the help of the Affordable Care Act (ACA), health care providers and insurance companies are prohibited to discriminate against gender identity and sexual orientation. The ACA became a law on March 23, 2010, and has been fully implemented since 2015. However, personal beliefs and opinions can still cause roadblocks in getting LGBTQ patients appropriate care.
Leading healthcare organizations are now making it a priority to provide sensitive care for individuals who identify as bisexual, gay, lesbian, and transgender; however, there are still many gaps when it comes to caring for these types of patients.
Tips to Teach Culturally Competent Healthcare
Healthcare simulation educators have a responsibility to address this in classrooms and sim labs. It is important to teach students acceptance and patience when treating any patient, but especially in marginalized populations. The more welcoming healthcare providers are with patients, the more comfortable they will feel seeking out care and opening up about medical issues they are experiencing.
Teaching these fundamental steps can ensure acceptable care for all:
1. Broaden knowledge about LGBTQ, sexual orientation (SO), and gender identity (GI). Sexuality encompasses a spectrum of needs, desires, and behaviors that can be fluid over time.
2. Teach key LGBTQ definitions. Teach the proper definitions of asexual, gay, lesbian, pansexual, and queer. Teach the meanings of agender, cisgender, transgender, and gender fluid.
3. Create a welcoming environment. LGBTQ patients are used to scanning their environments for welcoming signs. Teaching students how to post visible signs for this community will help set patients as ease. Post an organization’s non-discrimination policy; show a pink triangle or rainbow sticker. Share health education literature that includes diverse images and inclusive language.
4. Use non-offensive and inclusive language. Use gender neutral language. It takes some practice, but like anything else, it can be learned.
5. Let the patient talk, and don’t assume. Open-ended questions will help patients communicate their needs better. Focus on the reason they are seeking healthcare, and don’t ask irrelevant questions. It is not a patient’s job to educate healthcare providers.
6. Investigate specific health risks only present in the LGBTQ community. LGBTQ individuals are exposed to risks and diseases that heterosexual individuals may not be exposed to. This population is at greater risk for mental health issues relating to anxiety and depression. LGBTQ people who are part of another minority group can face other discrimination issues as well.
7. Become aware of health resources designed for LGBTQ patients. Make referrals as appropriate.
The most important thing to teach students is to convey respect to LGBTQ patients – just as they would with any other patient. Simulation scenarios that include LGBTQ simulated patients will broaden students’ knowledge, increase safety for LGBTQ patients, and create positive experiences for the wider community. Positive and affirming interactions with healthcare providers are life-saving.
Kurtis Kabel is a Pocket Nurse Account Manager, for the South East Region of the United States. He is on Twitter at @KurtPocketNurse.