• Article
  • June 23, 2021

Training to Improve the Health Care Experience for LGBTQ Patients

Children's hospital's training curriculum and programs aim to provide medical students and residents the skills to identify and appropriately address LGBTQ health concerns.

The numbers present a sobering reminder of the challenges lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) adolescents and teens face.

According to a recently released survey conducted by The Trevor Project, a national organization providing crisis intervention and suicide prevention services to LGBTQ people under the age of 25, 42% of LGBTQ youth—including more than half of transgender and nonbinary youth—seriously considered attempting suicide in the past year.

But those risks can be greatly diminished if even one person in an LGBTQ youth's life provides support for their gender or sexual identity.

With that in mind, leaders at Children's Hospital at Montefiore (CHAM) in Bronx, New York, are striving to create a more welcoming environment to this vulnerable population. "Our goal is not to help a patient come out if they might not feel comfortable coming out to their friends or family," says Lauren Roth, M.D., pediatrician, CHAM.

"But you might be the only person they trust with this information. That can be a heavy weight for a pediatrician to carry, but it's important for the patient to feel safe—if they trust you, you can be that person they talk to about the things they're experiencing."

Initiatives intended to foster LGBTQ understanding, inclusion

CHAM's efforts focus on reducing discrimination and improving the health care experience for LGBTQ youth by educating the oncoming generation of physicians to properly care for this patient population.

Among the programs underway at CHAM:

  • Lecture series. Roth and her team host a series of educational presentations around culturally humble care, which have included a panel with LGBTQ patients on their experiences in the health care system.
  • Grand rounds. Monthly rounds focusing on a variety of topics around sexual and gender minority care with opportunities to earn CME and CE credits.
  • Clinic training. During their adolescent medicine rotation, pediatric residents spend time in a community based specialty clinic that provides screening, treatment and sexual health care services—this gives residents increased exposure to the LGBTQ population and provides awareness about appropriate ways to address different gender identities.

In addition to the educational sessions, CHAM is planning to implement preferred gender pronouns on residents' ID badges. The message to LGBTQ youth from these initiatives is meant to be one of acceptance.

"To facilitate young people opening up to us and being responsive to our questions, we have to signal to them in so many ways that this is not only a safe environment, but we are open to hearing about their experiences and who they are," says Neal Hoffman, M.D., adolescent medicine specialist, CHAM.

Uniform LGBTQ curriculum a necessity

As co-chair of the LGBTQ Health and Well-Being Special Interest Group of the Academic Pediatric Association, Roth is also working on developing a nationwide pediatric LGBTQ curriculum and competencies for medical students and residents on how to provide gender-affirming care.

Roth says this is essential not only to establishing universal guidelines across pediatric medicine but also to providing consistency for physicians who may continue their health care careers in other regions around the country.

"It's really important for it to be uniform because there is a lot of misinformation out there—it's important for patients and parents to not get conflicting information from different providers," Roth says.

"Every patient is an individual and might take a different path, but there are really good guidelines out there—and we want to disseminate that information as much as we can."

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