LGBTQIA+ patients: How 'telling' can improve your care
7/24/2023 by Matthew Heinrich, M.D., and Denise Dupras, M.D., Ph.D.
We learned that a policy of "don't ask, don't tell" doesn't work — particularly when it comes to giving our LGBTQIA+ patients the most appropriate healthcare. The fear of stigma, discrimination, negative reactions and even denial of care can keep patients from revealing their sexual orientation or gender identity to their healthcare team. Here are three reasons how "telling" — and making sure it's part of your electronic health record — can help support LGBTQI patients' health.
#1: Minimizes barriers to healthcare
Asking questions about gender identity and sexual orientation can help minimize barriers between patients and their care teams, letting patients know they're seen, heard and respected, while keeping the information confidential. By sharing with your care team, our staff can use preferred names, pronouns and other language to respectfully communicate with you. Collecting information about gender identity and sexual orientation and documenting it in your electronic health record can reduce stress when seen by other clinicians.
These questions also may make non-LGBT-identified individuals feel more comfortable discussing issues of sexual, gender or reproductive health.
#2: Provides a basis for delivering the most appropriate care
Knowing a patient's self-identification helps providers and care teams identify the risk factors and provide personalized recommendations for screening, prevention and treatment of medical conditions. Healthcare clinicians may not consider medical conditions related to your anatomy due to assumptions based on appearance. For example:
- Rates of cervical cancer are higher among cisgender lesbian and bisexual women compared to cisgender heterosexual women. By informing you of these statistics, your clinician can highlight the importance of cervical cancer screening.
- In transgender women who undergo gender-affirmation surgery, the prostate is kept intact. Without this information, your clinician may not discuss screening for prostate cancer.
- If a patient was assigned male at birth but identifies as female, it's helpful to know if they've been seen by a gender specialist of if they've undergone gender-affirming surgery or hormone therapy, which may create a risk factor for certain conditions..
#3: Encourages comprehensive care, fosters patient-care team relationship
The role of the care team is to provide patient-centered care founded on scientific evidence, clinical expertise, availability of resources and equity. With the knowledge of a patient's gender identity and sexual orientation, your care team can make referrals and coordinate resources tailored to you.
By self-identifying to their care team, LGBTQIA+ patients feel more affirmed and understood by their care team, which may strengthen their engagement with a treatment plan.
Matthew Heinrich, M.D., is a physician in the Department of Medicine Primary Care Clinic located in the Baldwin building in Rochester, Minnesota. He earned his medical degree at Texas Tech University Health Sciences Center School of Medicine in Lubbock, Texas. His interests include primary care, evidence-based medicine and care of LGBTQIA+ patients.
Denise Dupras, M.D., Ph.D., is a physician in Community Internal Medicine, Geriatrics and Palliative Care at Mayo Clinic in Rochester. She earned her medical and doctoral degrees at Mayo Clinic Alix School of Medicine and completed her residency in internal medicine at Mayo Clinic in Rochester. Her interests include medical education, evidence-based medicine and care of LGBTQIA+ patients.