LGBTQ Health Care: Answers from Expert Paula Neira
Looking for a health care provider is never easy, but for lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) individuals, the search is especially challenging. Faced with inadequate — and sometimes hostile — care, many LGBTQ patients are understandably reluctant to share their sexual orientation and gender identity. Paula M. Neira, Program Director of LGBTQ+ Equity and Education, Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, lawyer and former naval officer, explains the importance of coming out and offers advice for finding the right doctor.
How can I find an LGBTQ-friendly provider?
Unfortunately, there’s no easy way to gauge a doctor’s familiarity with LGBTQ care. Organizations like GLMA: Health Professionals Advancing LGBTQ Equality have created databases to help patients find knowledgeable providers, but options are limited in certain areas. Most patients will need to do their own homework to find a supportive clinician.
To make sure that the doctor you’ve found is a good fit, have an open conversation during your first appointment. Although you may be fearful of discrimination, open and honest communication is vital to quality medical care.
When meeting with a new physician, start with a question as simple as, “What experience do you have caring for LGBTQ patients?” If your provider is not familiar with this area, ask if he or she has colleagues who are. If you encounter hostility, you will need to look elsewhere. Remember, your doctor should be a source of support — not judgment.
Why is it so important to be out?
In short, because your health depends on it.
Although members of the LGBTQ community have many health needs in common with everyone else — LGBTQ people catch colds, get injured and share health risks with others of their gender, race and ethnicity — there are some unique care concerns that are important to discuss with a doctor. If you are not open with your provider, he or she may make presumptions about you and your health care. For LGBTQ patients, that can mean missed screenings for potentially life-threatening conditions, such as ovarian and prostate cancer.
Transgender individuals, in particular, can benefit from coming out to their doctors. Medical support, including hormones, therapy and gender-affirming surgery, are options to help you to be your authentic self.
Learn more about LGBTQ-specific health concerns:
An estimated seven out of 10 LGBTQ patients have experienced negative care. Because of this, they often avoid health care settings, which leads to fewer doctor’s visits and poorer health outcomes. Coming out may help these patients connect with a competent provider who can eliminate some of that concern, allowing them to seek routine care without the fear of violence or harassment.
For far too long, lesbian, gay, bisexual and transgender individuals have been invisible in health care. This is especially true for transgender patients, whose medical needs are often ignored or denied. Revealing your true identity to your doctor is liberating. By speaking up, you have the ability to empower yourself and other LGBTQ patients who follow your example.
What’s being done to improve care for LGBTQ patients?
While the industry as a whole has a long way to go, health care systems across the country are finally recognizing their responsibility to provide quality care to all — regardless of sexual orientation or gender identity.
One project, the EQUALITY study, is looking to change how health care providers in emergency rooms gather information about sexual orientation and gender identity. With better data, health care professionals can more easily identify the unmet needs of LGBTQ patients and generate more effective solutions.
Other initiatives are giving medical students the knowledge they need to provide appropriate care. An updated medical curriculum from the Johns Hopkins University School of Medicine enables trainees to connect with — and care for — the diverse patient populations they’ll serve.