Supporting LGBTQ+ Healthcare Access

As we celebrate LGBTQ+ History Month,  it's essential to acknowledge not only the progress made in LGBTQ+ rights but also the ongoing challenges faced by the community, particularly in accessing healthcare. Despite advancements, discrimination, stigma, and inadequate healthcare access continue to impact LGBTQ+ individuals disproportionately. 

Healthcare providers must educate themselves on LGBTQ+ history, health concerns, and communication skills to ensure compassionate care and improved patient outcomes. Understanding the unique challenges faced by LGBTQ+ individuals, including higher rates of tobacco use, STIs, and mental health conditions, is essential for delivering effective care. It’s important that we develop an environment within healthcare which not only understands LGBTQ+ challenges, but also advocates and empowers LGBTQ+ patients to support their healthcare. 

This year's LGBTQ+ History month is focusing on Medicine - #UnderTheScope so we wanted to highlight the challenges faced by the LGBTQ+ community and how medical professionals can support to reduce the inequalities experienced in healthcare. 

Challenges Faced by the LGBTQ+ Community 

1. Stigmatisation: Common health concerns, such as sexual health, gender-affirming care, or mental health issues, may be stigmatised by healthcare providers leading to a delay in access and impacting treatment outcomes. 
2. Discrimination: LGBTQ+ individuals may experience mistreatment based on their identity, which may lead to future avoidance of healthcare services and an ability to disclose important information relating to their health. Lack of legal protections against discrimination based on sexual orientation or gender identity may also contribute to discriminatory practices in healthcare settings.
3. Heteronormative Assumptions: Healthcare environments may operate within a heteronormative framework, assuming all patients are heterosexual and cisgender. This can lead to feelings of marginalisation, impacting an individual’s  trust and willingness to discuss their health concerns with a clinician. 
4. Legal and Policy Barriers: Legal barriers, such as restrictions on gender-affirming healthcare or discriminatory healthcare policies, can limit LGBTQ+ individuals' access to essential services. 
5. Lack of Cultural Competency: Healthcare providers may lack understanding or training in LGBTQ+ health issues, leading to insensitive or discriminatory treatment. This can result in LGBTQ+ patients feeling misunderstood, invalidated, or reluctant to seek care.

Medical Conditions to be aware of:

Research suggests that LGBTQ+ individuals have a higher rate of suicidal ideation, anxiety, depression, stress, and eating disorders, leading to increased support required for mental health care. 

Studies indicate that LGBTQ+ individuals face a higher risk of sexually transmitted diseases. The NHS provides screening guidelines for screening programmes available in the UK and how this is applicable for trans and non-binary individuals. However, discussing sexual health can be stigmatising, especially for LGBTQ+ people. Therefore, it's crucial for healthcare providers to approach these conversations in a supportive yet effective manner, prioritising the individual's health.

FInally, studies have shown that the use of gender-affirming hormones has been associated with poor cardiovascular health in transgender people due to the cardiovascular effects of these treatments. Having an awareness of this will mean the appropriate tests can be performed to ensure an individual's health is not being affected by their medication. 

Having an awareness of health conditions that LGTBQ+ individuals may be more susceptible to is important, however this is only half the issue. It’s vital to ensure we are competent surrounding LGBTQ+ challenges, and how best to support them to ensure they feel held and assisted throughout their care.  

Strategies for Support:

1. Education and Training: Healthcare providers should undergo comprehensive training on LGBTQ+ health issues, including cultural competency and respectful communication. Getting someone from the LGBTQ+ community to share previous experiences, both negative and positive, can be a great way to understand how to adapt your behaviour and support patients in the future. 
2. Creating Safe Spaces: Establishing LGBTQ+ inclusive healthcare environments where individuals feel safe and respected is crucial. This can involve visible displays of support, inclusive language, and supporting LGBTQ+ affirming policies on a local, national and institutional level to dismantle systemic barriers such as updating electronic medical records to allow the use of correct terminology. 
3. Offer LGBTQ+ Specific Care: If a person needs it, demonstrate your understanding of the LGBTQ+ community by supporting them with specialist services such as gender-affirming care, mental health support, and HIV/AIDS prevention and treatment. However, it is also important to recognise that not all LGBTQ+ individuals will require these services, but providing them when required is essential. 
4. Understand Unique LGBTQ+ Experiences: Show empathy to patients by learning about things unique to LGBTQ+ individuals such as gender modification surgeries, sexual acts and experiences, gender-affirming hormones, and how previous experiences with clinicians may have impacted their trust to future healthcare providers.
5. Use Appropriate Language: Demonstrate your understanding of LGBTQ+ terms to help your patient feel heard, challenge your personal beliefs to ensure you don’t come across as uncomfortable when individuals are discussing their gender or sexual identity and avoid using derogatory terms even if the patient uses them. 
6. Remain Confidential: As with any patient, conversations should not be shared with other people. Some members of the LGBTQ+ community may not make their gender or sexual orientation public or be used to discussing their relationships with others. Be compassionate during these conversations, and ensure the patient is aware that their medical records, including tests and results, are confidential.
7. Make No Assumptions: Providers should not assume gender or sexuality. While sex may be documented, it is essential to be culturally sensitive and use the name they wish to be called. Use gender-neutral terminology, listen to the terms used by the individual, and ask them how they identify in order to understand their gender and sexuality. 

It is vital that LGBTQ+ individuals have access to the supportive and effective healthcare they require. During LGBTQ+ History Month and beyond, eMed is committed to creating inclusive healthcare environments where LGBTQ+ individuals feel valued, respected, and supported. We are addressing systemic barriers and promoting cultural competency to ensure that everyone, regardless of sexual orientation or gender identity, has access to the quality healthcare they deserve. At eMed, we are committed to working towards a future where LGBTQ+ individuals can seek healthcare without fear of discrimination or prejudice.