February 2018
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Improving cultural
sensitivity and health care for the LGBTQ community
“I don’t feel comfortable sharing my
sexual identity during a visit to the doctor, so I just don’t go.”
“Every time I go in, I have to explain to a new
person who I am.”
These types of issues are shared when the LGBTQ
community is asked about barriers to health care. Many feel their health care
providers don’t understand how to address their sexual identity. The provider’s
office only offers “male,” “female” or “other” as selections on intake forms,
and there is a lack of trust for the provider’s confidentiality.[1] The
Transgender Law Center cited a study showing that half of transgender adults
had to teach their medical providers about transgender care. About 15% were
denied gender-specific care, such as Pap smears for transgender men and
prostate exams for transgender women.[2]
Starting
with cultural sensitivity
The Alaska Section of Chronic Disease Prevention
and Health Promotion (CDPHP) worked with community partners to improve cultural
sensitivity and health care for LGBTQ people. CDPHP staff received cultural awareness
training by an Anchorage-based nonprofit organization called Identity,
Inc. Identity, Inc. repeated the training with
Alaska Comprehensive Cancer Partnership members. The “Culturally Proficient
Care for LGBTQ People” training included discussions about gender identity,
gender expression and sexual orientation, as well as health disparities experienced
by the LGBTQ community.
Improving health care
related to cancer
Identity, Inc. offered a second training to
members of the Alaska Comprehensive Cancer Partnership on how to become a
welcoming oncology practice. LGBTQ people face a higher risk of cancer,
resulting in a greater cancer incidence rate and later stage of diagnosis.
These disparities are caused by a combination of social and economic factors
and behaviors, many of which can be traced to the stress of living as a sexual
and gender minority.[3]
During the training, Identity, Inc. reviewed
forms to include options for gender identity and sexual orientation. They
discussed barriers for LGBTQ patients, such as gender-neutral bathrooms,
insurance forms and cancer screenings. Staff at two oncology offices in Alaska said
they were interested in adopting best practices for working with LGBTQ patients.
These oncology offices in Alaska have completed training of their nursing staff
in cultural awareness and reviewed their practices for other opportunities to
be welcoming. In addition, Identity, Inc. offered their expertise during Grand
Rounds at two local hospitals.
Addressing
tobacco use among LGB adults
Decades of research and reports in a few states
have shown that lesbian, gay, and bisexual (LGB) adults are more likely to
smoke and use tobacco products compared to heterosexual adults. Alaska’s
Behavioral Risk Factor Surveillance System (BRFSS) did not begin collecting
data on sexual orientation until 2012; a question on transgender status was
only recently added to the survey so data are not yet available. Data compiled
from 2012–2015 found that lesbian and bisexual women are more likely than
heterosexual women to smoke and use e-cigarettes. In addition, LGB adult
nonsmokers are less likely than heterosexual nonsmokers to have a smokefree
policy in their home.[4]
Finding
more assistance to improve care
A national program called LGBT Healthlink,
which is a part of Centerlink, provides more assistance to improve patient care
for LGBTQ patients. LGBTQ Healthlink is a community-driven network of experts
and professionals improving LGBTQ health by reducing tobacco use, cancer, and
other health disparities within the LGBTQ community. The program is one of
eight cancer and tobacco disparity networks funded through the Centers for
Disease Control and Prevention.
LGBT Healthlink connects
individuals and programs with information to promote adopting best practices in
health departments and community organizations to reduce LGBTQ cancer and
tobacco disparities. The program maintains a virtual forum of LGBTQ tobacco and
wellness professionals, encouraging them to share lessons learned and monitor areas
that need improvement.
References:
-
Identity, Inc. 2015 Training Presentation.
- Transgender Law Center. 2008 The State of Transgender California Report. Accessed January 23, 2018. Page 12.
-
National LGBT Cancer Network. Cancer
Burden Report.
Accessed January 2, 2018.
- State of Alaska Tobacco Prevention and Control Program. Tobacco Use Among
Lesbian, Gay and Bisexual Alaska Adults – 2017.
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