LGBTQ+ Health - Student Guide PDF

LGBTQ+ Health Carolanne Wartman, PharmD, BCPS, BCPP (she/her) Population and Rural Health 3/6/2024 Learning Objectives 1. Define key LGBTQ+ terminology, including terms related to gender identity, sexual orientation, and intersectionality. 2. Identify unique healthcare disparities and social determi...

LGBTQ+ Health Carolanne Wartman, PharmD, BCPS, BCPP (she/her) Population and Rural Health 3/6/2024 Learning Objectives 1. Define key LGBTQ+ terminology, including terms related to gender identity, sexual orientation, and intersectionality. 2. Identify unique healthcare disparities and social determinants of health faced by LGBTQ+ individuals. 3. Describe methods for creating inclusive healthcare environments that respect and affirm diverse gender identities and sexual orientations, with an emphasis on appropriate language. 4. Demonstrate effective communication skills for building trust and rapport with LGBTQ+ patients, including the use of affirming language and active listening techniques. Identifying as LGBTQ+ is not a mental illness or disorder Stigma towards LGBTQ+ patients is present among healthcare providers 28% of LGBT patients reported postponing care for fear of discrimination 1 in 4 individuals experienced health insurance issues due to being transgender 50% of LGBT patients reports seeing providers who were unable to address their needs due to lack of knowledge 24% of respondents did not see a doctor when they needed to due to fear of mistreatment 28% did not see a doctor when they needed to in the last 12 months due to cost 48% of individuals reported having at least one negative experience with a healthcare provider Why is this important ? Gender Identity vs. Sexual Orientation Gender Identity: Sexual Orientation: Inherent sense of being male, female, both, or neither regardless of physical sex characteristics Inherent or immutable enduring emotional, romantic, or sexual attraction to other people Common Gender Identity Terminology Cisgender Transgender Agendered TransSexual Someone whose gender identity aligns with the sex assigned at birth Someone whose gender identity differs from the cultural expectations based on the sex assigned at birth Someone who does not identify with a gender Historical medical term for someone who changes their gender expression to match their gender identity MtF (male to female): born male, but transitioned to female FtM (female to male): born female, but transitioned to male Transition Non-Binary Intersex Period during which a transgender individual adapts or presents themselves as a member of the other sex – may include social changes (name/pronouns, appearance, identification) and/or bio-physical changes (hormone therapy, gender-affirming surgery) Individuals who do not identify as man or woman Genderfluid, genderqueer, gender diverse, etc. Individuals who are born with sexual anatomy and/or chromosome pattern that do not seem to fit typical definitions Respect Pronouns Include pronouns in email signatures, on presentations, etc.. UM Milwaukee. LGBTQ+ Resource Center. Gender Pronouns. Subjective Objective Possessiv e Reflexive She Her Her Herself He Him His Himself They Them Their Themselves Ze Zir Zir/Zirs Zirself Xe Xem Xyr/Xyrself Xemself Ze Hir Hir/Hirs Hirself Per Per Per/Pers Perself - She excused herself from the meeting. - He excused himself from the meeting. - They excused themselves from the meeting. - Ze excused hirself from Common Sexual Orientation Terminology Heterosexual Gay Bisexual Attracted to people of the opposite sex “Straight” A person who is attracted primarily to members of the same gender. Most frequently used to describe men who are attracted primarily to other men, although it can be used for men and women. Attracted to both people of the same and opposite sex Asexual Demisexual Pansexual No sexual attraction towards other people Sexual attraction only once a strong emotional connection has been made Not limited in sexual choice or attraction with regard to biological sex, gender, or gender identity The ”Q” Can reflect someone “questioning” sexual orientation or gender identity (SOGI) Can stand for “queer,” the umbrella term describing people who identify their SOGI outside of societal norms - A more fluid and inclusive term - Historically, considered a slur, but has been reclaimed by many as a term of empowerment Social Determinants of Health and Health Disparities LGBT Poverty in the United States Social Determinants of Health for LGBTQ LGBTQ+ Mental Health Disparities The LGBTQ+ community is at a higher risk for experiencing mental health conditions… Depression and Suicide Anxiety Trauma Substance Use Disorder PostTraumatic Stress Disorder Eating Disorders Personality Disorders United States Transgender Surveys 44% of respondents experienced serious psychological distress in the last 30 days Role of the Healthcare Professional A cknowledge: the challenges faced by the LGBTQ+ community implicit bias, explicit bias, I dentify: stereotyping, and competency gaps disparities in LGBTQ+ A ddress: healthcare an inclusive, non-judgemental C reate: environment by asking for pronouns and using gender-inclusive language NAMI. Your Journey. LGBTQI. Addressing Disparities in Healthcare GLMA Guidelines for the Care of Lesbian, Gay, Bisexual, and Transgender Patients: Offer and perform pertinent health screenings, such as depression (PHQ-9), anxiety (GAD-7), substance use (NM-ASSIST), and STI/HIV tests Ensure appropriate cancer screenings, such as breast cancer (mammograms), cervical cancer (pap smears), prostate cancer, etc. Refer to financial counselors and/or care coordinators when needed to address barriers in insurance, housing, etc. Providing a Welcoming Environment Visual cues that your practice is a safe place Include LGBTQ+ educational brochures and publish your non-discriminatory policy publicly Collecting SOGI information should happen routinely. Update intake forms with genderinclusive language: How would you like our staff to refer to you? Including a section for name and pronouns What was your sex assigned at birth? How would you best describe your gender? How would you best describe your sexual Utilizing Inclusive Language Examples “Hi, my name is CC and I use she/her pronouns. Your chart lists your name as XYZ. What would you like me to call you? (what’s your name?)” ”What name would you like me to list on your medication bottle?” ”Who lives with you? How would you describe those relationships you have with those at home?” “Do you have a significant other, partner, or spouse?” (If screening for STIs, cancer screenings [HPV], pregnancy potential) “What types of sexual contact do you have with others?” ”What questions or concerns can I address for you about your sexual health or gender identity?” What if there is a disconnect? Respectfully clarify when a patient’s name or gender identity do not match what is on record Could your chart be under a different name? NEVER assume, follow the patient’s lead with language If you mess up, apologize and move on Stars Activity Goals: Describe aspects of the “coming out” process Discuss the feelings associated with identifying as LGBTQ+ Explain how this activity will impact your relationship with your patients who identify as LGBTQ+ LGBTQ+ Health Carolanne Wartman, PharmD, BCPS, BCPP (she/her) Population and Rural Health 3/6/2024