Improving the Health Care Experience for LGBTQ+ Patients

Improving the Health Care Experience for LGBTQ+ Patients

Here are several initiatives aimed at reducing discrimination and improving the health care experience for LGBTQ+ youth.
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The numbers present a sobering reminder of the challenges lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ+) adolescents and teens face.

According to a recent survey conducted by The Trevor Project, a national organization providing crisis intervention and suicide prevention services to LGBTQ+ people under the age of 25, 45% 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 reduced 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 working to create a more welcoming environment for this population. "As pediatricians, we have the opportunity to provide a safe and affirming space for all of our patients, but especially those who identify as transgender, nonbinary or somewhere on the gender spectrum," says Lauren Roth, M.D., a pediatrician at CHAM. "You can make an enormous impact in a person’s life just by being someone they can trust."

Initiatives 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.

Here are some programs underway at CHAM:

Curriculum sessions. Roth and her team host a workshop embedded within the regular resident curriculum, including case-based learning and a patient/caregiver panel about gender-affirming care and the experiences of transgender and nonbinary youth and adolescents in the health care system.

Grand rounds. The Trans Wellness Centers at Montefiore present the “Sexual and Gender Minority Health Grand Rounds” monthly, focusing on a variety of topics around gender-affirming 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.

Physician education. Roth and her team made presentations this year to large groups of CHAM’s attending pediatricians and faculty on gender identity development, terminology and best practices for gender-affirming care.

In addition to the educational sessions, CHAM includes preferred gender pronouns on residents' ID badges. The message to LGBTQ+ youth from these initiatives is meant to be 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., an adolescent medicine specialist at 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 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 is more important now than ever to continue to educate current and future physicians about the importance of being inclusive and affirming for all patients, regardless of their gender identity," Roth says.

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