I recently attended webinar hosted by the American Society for Healthcare Human Resources Administration (ASHHRA) titled, “Ensuring Access and High-Quality Care for LGBT Patients,” which discussed the existing health disparities for lesbian, gay, bisexual, and transgender (LGBT) people. Unfortunately, studies show the impact of stigma and discrimination on this group and the quality of care available to them. According to Dr. Harvey Makadon, Professor of Medicine at Harvard Medical School, there is too little training and attention to the kind of communication needed to create an inclusive and caring environment.  

Here’s a closer look at this issue and how healthcare organizations like yours can work towards creating an inclusive environment for all patients.

The Health Disparities of LGBT Patients

Recent studies have shown that health disparities among LGBT people occur across the life cycle. According to Healthy People 2020, a resource by the Office of Disease Prevention and Health Promotion, research suggests that LGBT individuals face these health disparities linked to societal stigma, discrimination, and denial of their civil and human rights. Specifically, LGBT health requires specific attention from healthcare and public health professionals to address a number of disparities, including:

• LGBT youth are 2 to 3 times more likely to attempt suicide.
• Lesbians are less likely to get preventive services for cancer.
• Elderly LGBT individuals face additional barriers to health because of isolation and lack of social services and culturally competent providers.
• LGBT populations have the highest rates of tobacco, alcohol, and other drug use.

Given these disparities, it’s important for healthcare organizations to take steps to help this group of people get access to the care that they need.

Providing Better Care for LGBT Patients

The following are a few ways healthcare organizations can take steps to help LGBT patients overcome these health disparities by providing them with higher quality care.

1. Use the HRET Disparities Toolkit - The American Hospital Association’s (AHA) Health Research and Educational Trust (HRET) Disparities Toolkit is a great resource for healthcare organizations. The Toolkit is useful for educating and informing healthcare organizations and their staff about the importance of data collection, how to implement a framework to collect race, ethnicity, and primary language data to ultimately use these data to improve quality of care for all patient populations.
2. Collect Sexual Orientation and Gender Identity Data - The Institute of Medicine and The Joint Commission recommend that information on patients’ sexual orientation and gender identity should be collected in electronic health records (EHR), just as information on race and ethnicity is routinely collected. In a 2014 study by Cahill et al, LGBT respondents of all ages overwhelmingly expressed support for asking these questions and understood the importance of providers’ knowing their patients’ sexual orientation and gender identity.
3. Review Your Organization’s Nondiscrimination Policy - The Joint Commission requires healthcare organizations to have a nondiscrimination policy that includes sexual orientation, gender identity and gender expression (Joint Commission standard RI.01.01.01, EP 29). While having a policy is the first step, it takes more work to “make it real.” For more information on documenting a patient nondiscrimination policy, refer to this article on the Human Rights Campaign’s (HRC) Healthcare Equality Index (HEI).
4. Educate Your Clinicians and Staff on LGBT Health Issues - Some people don’t know what LGBT means, so it’s important to know that up to recently this has been a relatively invisible patient group. According to Dr. John Knudsen, Director of Office of Health Equity and Inclusion at Mayo Clinic, healthcare organizations should be training people about what questions shouldn’t be asked out of curiosity. Dr. Makadon stresses the importance of educating consumers as well as clinicians, as these are the only ways healthcare organizations can provide patient centered care that is inclusive to what the AHA is trying to achieve.
5. Get Acquainted With Available Resources - The National LGBT Health Education Center provides educational programs, resources, and consultation to healthcare organizations. Their website features resources for healthcare organizations to train their staff on LGBT health issues including video training, webinars, suggested readings, and other publications, including Ten Things: Creating Inclusive Health Care Environments for LGBT People. Their live and on-demand LGBT Health webinar series feature key topics on LGBT health and offer free continuing education credits that can be used for clinicians of different types.

LGBT patients are affected by significant health disparities. With the right vision and proper planning, however, healthcare organizations can empower their clinicians and staff to provide better care for this often invisible patient group. The desired result--a more inclusive and affirming healthcare environment that improves both quality of care and patient satisfaction.