Suggestions to Improve Health Care for Lesbian, Gay, Bisexual & Transgender Patients

Suggestions for how you can improve care to LGBT patients include the following:

• Prominently post a nondiscrimination policy that includes sexual orientation and gender identity.
  
• Participate in training on gay and lesbian health concerns conducted by local gay and lesbian organizations.
  
• Train clinical and administrative staff on lesbian issues. Make sure all staff understand that patients’ known or perceived sexual orientation should not have any effect on how they are treated or services are provided.
  
• Communicate a safe environment to facilitate discussion during interviews and “small talk.” Use non-judgmental and gender-neutral language.
  
• Use open-ended questions about health behaviors and needs. Ask about sexual history rather than making assumptions about a patient’s sexual orientation.
  
• Make no assumptions about the client’s behavior or health needs. Ask her what language to use to describe her relationships, sexual behaviors, and health concerns, then use that language.
  
• Discuss confidentiality, including documentation and access to records. Prior to taking a sexual history, repeat a pledge of confidentiality.
  
• Use inclusive, gender-neutral language on all forms.
  
• Respect the client’s needs to disclose (or not disclose) sexual orientation.
  
• Distribute gender-neutral brochures so the patient will feel more comfortable and identify with health messages.
  
• Provide access and referrals to print resources and area services for lesbians/bisexual women.
  
• In waiting rooms and offices, place magazines, newspapers, and posters that are inclusive of and specific to LGBT people.
  
• Conduct patient satisfaction surveys with gays and lesbians who have disclosed their sexual orientation to determine if there are ways to improve health services.
  
• If the client wishes, include her significant other or family of choice in health care discussions. Make sure same-sex partners are recognized as valid with regard to visiting hours, legal documents (i.e., power of attorney or guardianship forms), and receiving information about a patient or client.
  
• Advertise and “come out” in the community as lesbian-affirming.
  
• Be aware of your own bias, values, and limits of knowledge. Realize that your tone of voice and facial expressions are important. Any discomfort you have will probably show.
  
• Recognize that body language is a subtle expression of discomfort. A hostile reaction from a lesbian patient may indicate her discomfort with your difficulties regarding her sexuality.
  
• Remember your commitment to ensuring quality care for all.

Resources
Matthew Murguia, “Addressing the Health Needs of Gay & Lesbian Patients,” Closing the Gap, August/September 1999.

Mautner Project for Lesbian Health, “Checklist for Optimal Care of Lesbian Clients.”

The Women’s Cancer Resource Center, “Practical Suggestions for an Accepting Health Care Environment for Lesbians.”