Our expert is Patricia Robertson, Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.

If there is a medical topic you would like to see explored here, please let me know!

Very best,

Mitzi Perdue

MPerdue@LiebertPub.com

LESBIAN AND BISEXUAL WOMEN’S HEALTH NEEDS ARE UNDERSERVED

The health needs of lesbian and bisexual women are not well served.  One of the areas where improvement is particularly needed is research, including funding for research. Insufficient research on LGBT health issues translates into worse health outcomes. The Lesbian Health Fund of the Gay and Lesbian Medical Association provides a number of starter grants which enable researchers to get pilot data that will then enable them to apply for larger grants. Still, in relation to the need and size of this population, available funding for these efforts is a drop in the bucket.

YOUR PATIENTS MAY BE HESITANT TO REVEAL THEIR SEXUAL PREFERENCES

We know that most lesbians and bisexual women would like to have their health care provider know about their sexual orientation. They understand that this information can be highly relevant to their health screening and treatment. However, you may find that many of your patients will be reticent to divulge this kind of information. They may be silent about their sexual orientation because they’ve had a negative health experience in the past. The negative experience may have come from a homophobic health care provider, or from individuals at the front desk who were condescending or dismissive. Your patients are also likely to feel that they’re putting their life in the hands of their health care provider when it comes to confidentiality. Lesbian or bi-sexual women of color may be particularly reluctant to reveal their status. Many who’ve had a negative experience or feel a lack of trust simply won’t come back or will delay seeking treatment until the condition is more difficult to treat.

CREATE A WELCOMING ENVIRONMENT

There are several things you can do to signal that yours is a hospitable environment and that individuals are safe in revealing their sexual orientation. One of the easiest is to have a rainbow sticker on the front door or at the front desk. A notice at the front desk saying that “We don’t discriminate” can also be helpful. Having magazines available that aren’t exclusively heterosexually oriented can be a signal that inclusiveness is valued in your office. It’s important to hire diverse individuals for the front desk.

WHEN HIRING, CONSIDER ATTITUDES ON DIVERSITY

When hiring, whether it’s for your clinic’s health care providers or the front desk, ask about their attitudes towards LGBT patients.  The goal is to make sure that no patient ever experiences a dismissive or condescending attitude. Several videos are available that can encourage members of your staff to handle diversity in a welcoming and appropriate manner. The AAMC (American Association of Medical Colleges) video is excellent. It’s available at: https://www.aamc.org/initiatives/diversity/learningseries/346528/howardrossinterview.html . Many of the professional societies also have valuable videos on diversity.

FAMILIAL ACCEPTANCE IS KEY TO POSITIVE HEALTH OUTCOMES.

Health care providers who are working with lesbian or bisexual women find that acceptance from the patient’s family is critical for positive health outcomes. Families from traditions that are particularly non-accepting of homosexuality, such as Mormons or Muslims, will nevertheless care deeply that their daughters don’t end up homeless, on drugs, or suicidal. The families may not like their daughters’ sexual orientation, but they nevertheless want the best for their children. If your patients are up against a family acceptance issue, a good resource for both your patients and you is Caitlin Ryan’s Family Acceptance Project, https://familyproject.sfsu.edu.

ELDERLY LGBT PATIENTS NEED ADVOCATES

Each LGBT generation is different, and elderly LGBT members have a particular set of issues.  When they lose their partner, their family may not support them in their grief, especially if they haven’t come out. They also may face so much LGBT discrimination in nursing homes that they go back into the closet when they enter these homes.

HOW YOU AS A HEALTH CARE PROVIDER CAN HELP

Your LGBT patients are a small minority, need allies to help them access health care, and to have health care that is free from discrimination. Consider being an ally to advocate for more research, more services, and less discrimination for your LGBT patients. You can make a difference!