Guest post: Excellent care for LGBTQ patients requires cultural humility and specific medical knowledge

Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The Catalyst welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and point of view.

In honor of LGBT Pride Month, we are pleased to share a blog post from Andrew Petroll, MD, MS is Associate Professor of Medicine (Division of Infectious Diseases) at the Medical College of Wisconsin (MCW).

Views represented here are those of the authors and may not reflect those of PhRMA.

Earlier this month, the health system in Milwaukee where I practice, Froedtert & the Medical College of Wisconsin health network, announced plans for an Inclusion Health Clinic, a clinic designed to offer a wide range of health care services to lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals. Opening this clinic is an important step toward ensuring that LGBTQ individuals have access to health care and health care professionals that both welcome and affirm them as individuals, as well as understand the health disparities faced by this population and offer the preventive measures and medical care that can improve their health outcomes.

Research shows that people in the U.S. who identify as LGBTQ experience multiple health disparities, including higher rates of HIV, obesity and its complications, tobacco use and its complications, depression and suicide and alcohol and recreational drug dependence than those found in the general population. However, research has also demonstrated LGBTQ individuals are less likely to seek or receive health care than their heterosexual counterparts. LGBTQ individuals report avoidance of health care providers and facilities due to perceived or actual experiences of culturally insensitive or medically incompetent care, and even outright discrimination in health care settings. Thus, LGBTQ populations simultaneously may have a higher need for health care services than non-LGBT individuals, yet are less likely to seek or receive them.  

Improving the health outcomes of LGBTQ individuals depends on factors relating to the health care environment. This may include implementation of policies that prevent discrimination against LGBTQ persons within health care settings, and developing clinical environments that welcome and affirm LGBTQ patients. Cultural humility – the concept of using a humble and respectful attitude toward each patient, understanding that one cannot know everything about all cultures, but making continued learning about other cultures an ongoing goal – can be an essential step in the development of a strong patient-provider relationship. This sets the stage for the patient to share essential information about themselves, their identity, and their behaviors that allows the provider, with the proper knowledge base, to deliver appropriate preventive care, perform needed diagnostic testing, and to assess a patient’s adherence to recommended treatments.

In addition, to having an approach that allows for easy interactions with LGBTQ patients, providers must also possess the medical knowledge necessary to care for them. Examples of such knowledge include knowing that vaccinations against hepatitis A and human papillomavirus are indicated in some men who have sex with men and understanding how to prescribe gender affirming hormone therapy for transgender patients.

GLMA: Health Professionals Advancing LGBT Equality is an organization dedicated to improving LGBTQ health through advocacy for policies that promote nondiscrimination in health care and enhance provider competency, educational opportunities for health professionals in training and current practitioners, and connecting LGBTQ individuals to competent health care providers through our extensive national Provider Directory. Educational resources for health care professionals interested in improving their competency in caring for LGBTQ patients include GLMA’s Annual Conference on LGBTQ Health, GLMA’s Top 10 LGBT Health Issues, and extensive online training available through the National LGBT Health Education Center.

 Andrew Petroll, MD, MS is Associate Professor of Medicine (Division of Infectious Diseases) at the Medical College of Wisconsin (MCW). His clinical practice focuses on the treatment and prevention of HIV. He is also the medical director of the Inclusion Health Clinic at Froedtert & the Medical College of Wisconsin. Dr. Petroll is Associate Professor of Psychiatry and Behavioral Medicine at MCW’s Center for AIDS Intervention Research. His research is aimed at increasing the delivery of HIV prevention services within healthcare settings and the development and testing of multi-level HIV prevention interventions for individuals and communities at risk for HIV acquisition. Dr. Petroll serves as a board member and the Treasurer of GLMA: Health Professionals Advancing LGBT Equality.