If you’re fortunate enough to attend medical school, you’re unlikely to ever take a class on LGBTQ health care. You won’t be able to specialize or earn board certifications in that field of medicine because it doesn’t exist. Once you begin your career in medicine, any specialized training opportunities you receive in LGBTQ care will be few and far between, and you’ll probably have to seek them out yourself.
These are the realities confronting health care providers today, and it should be little wonder that they result in poor outcomes for LGBTQ-identified patients. According to the Human Rights Campaign Foundation’s recent Healthcare Equality Index, 56% of gay, lesbian, or bisexual patients surveyed — and 70% of transgender or gender-nonconforming patients surveyed — reported experiencing some form of discrimination in health care.
At that level, experiences of discrimination become expected, and the mistrust of medical providers itself becomes a barrier for LGBTQ people. A provider’s bias might surface as an assumption that all gay men are living with HIV, or that patients who identify as bisexual always have multiple partners. For gender-diverse patients, discrimination can range from the irritation of incomplete forms which only offer the binary “M” and “F” for gender identity options, or the very dangerous indignity of being outed as transgender to an entire waiting room. There are also patients who are turned away from care altogether, either because the provider has had no training to take care of the patient, or because they believe that providing affirming care to the patient conflicts with their deeply held religious belief or a policy of the institution.
To us at The LGBT Health Resource Center of Chase Brexton Health Care, these statistics are deeply troubling, but they aren’t surprising. Why should they be, when medical students receive only cursory training in LGBTQ care; when there’s no way to certify a provider’s competency in that field; when health care organizations lack the resources for providers to receive continuing education in LGBTQ care — especially now, during the COVID-19 pandemic.
Chase Brexton Health Care was founded 40 years ago specifically to address this lack of welcoming, affirming care. Our center is proud to not just continue that work in LGBTQ health care equity today, but to now share it with other health care providers. We believe that is our mission, to create as much access to equitable care as possible, not just at institutions like Chase Brexton with a specialized focus, but everywhere.
To do this, we created our LGBTQ Health Equity Team, to help us educate providers in how to take their basic understanding and training to the next level and work toward creating true equity for their patients. We teach providers how to create a welcoming and affirming environment for health care and to understand the unique health disparities and risk factors that LGBTQ patients experience. We teach language and terminology, and cultural humility. We also teach the fundamentals of affirming gender care so that providers cannot only understand the broad spectrum of gender identities but gain the skills needed to support each patient’s individual health goals.
We have offered in-person symposiums, presented at many conferences, including internationally, and are now pivoting to digital platforms to ensure that providers can engage and learn even when in-person instruction is not ideal. Last year, we provided accredited learning to more than 1,000 providers nationwide. We have also found that the LGBTQ equity principles we teach are highly relevant to business leaders and large employers, and we train in those environments as well.
In that same Healthcare Equality Index, Chase Brexton Health Care was once again named a Leader in LGBTQ Healthcare Equality, one of only three institutions in Maryland so recognized. But to us, being a “leader” is not enough. True leadership is not standing above our fellow health care providers, but lifting them up so that they feel confident in delivering the competent, affirming LGBTQ care that they so often want to provide, and that their patients so desperately need.
Sam McClure (email@example.com) is the executive director of the LGBT Health Resource Center of Chase Brexton Health Care.