LGBTQ Patients Research Articles

Use of social media to assess the impact of equitable state policies on LGBTQ patient experiences: An exploratory study

Limited research has evaluated these equitable policies because of the difficulty of capturing LGBTQ patient experience. Previous studies have shown that LGBTQ persons report increased rates of discrimination across a wide variety of healthcare settings which may prevent them from disclosing their LGBTQ status. The goal of this research was to use a social media big dataset to evaluate the impact of equitable policies on patient experiences for LGBTQ persons.

Addressing Diversity in PTSD Treatment: Clinical Considerations and Guidance for the Treatment of PTSD in LGBTQ Populations.

Purpose of reviewTrauma exposure is widespread but is especially common among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. LGBTQ individuals also experience higher rates of discrimination, victimization, and minority stress which can complicate posttraumatic stress disorder (PTSD) treatment but also represent independent intervention targets. In this review, we highlight existing evidence-based practices, current limitations, and provide recommendations for care in the absence of established guidelines for treatment PTSD among LGBTQ patients.Recent findingsTrauma-focused therapies (e.g., CPT, PE) and medications (e.g., SSRIs, SNRIs) have shown benefit for people with PTSD. However, evaluations of these interventions have failed to examine the role of LGBTQ identities in recovery from trauma, and existing PTSD treatments do not account for ongoing threat to safety or the pervasive minority stress experienced by LGBTQ patients. In addition, many LGBTQ patients report negative experiences with healthcare, necessitating increased education and cultural awareness on the part of clinicians to provide patient-centered care and, potentially, corrective mental health treatment experiences.SummaryProviders should routinely assess trauma exposure, PTSD, and minority stress among LGBTQ patients. We provide assessment and screening recommendations, outline current evidence-based treatments, and suggest strategies for integrating existing treatments to treat PTSD among LGBTQ patients.

Understanding the Unique Needs for Members of LGBTQ Community in the Hematopoietic Stem Cell Transplant (HSCT) Setting: Improving Staff Accountability and Comfort through Education

Topic Significance & Study Purpose/Background/Rationale The LGBTQ community faces significant barriers to healthcare in the United States. Battling a cancer diagnosis and committing to a HSCT is daunting to all; fighting as a LGBTQ individual can be even more overwhelming. LGBTQ patients may experience stigma and discrimination in the health care system. Many approach their treatment expecting continued misunderstanding from healthcare professionals. Methods, Intervention, & Analysis The aim of this project was to educate the HSCT multi-disciplinary staff about healthcare disparities experienced by the LGBTQ community and to engender sensitivity among staff. Tools for effective communication were provided in order to deliver exceptional care to all patients. With appropriate permissions, a PowerPoint from the online National LGBTQ Health Education Center was presented at multiple teaching sessions for day and night shift staff. Further independent training through the National LGBTQ Health Education Center was encouraged and multiple open discussions were held with staff over a 6-month period. An anonymous Qualtrics survey was distributed at the end of the 6-month period to evaluate the effectiveness of the education. Findings & Interpretation Fifty-three staff members participated in training and 28 surveys were returned. Only twenty-one percent of respondents considered themselves knowledgeable about LGBTQ healthcare needs prior to this education. After completing the course, eighty-nine percent of respondents rated themselves as knowledgeable and all indicated that they are likely to utilize these communication skills to provide care to future LGBTQ patients. Discussion & Implications Providing appropriate education to healthcare professionals can increase awareness of LGBTQ needs and improve accountability for meeting those needs. Education and open dialogue are important steps toward embracing the LGBTQ community and delivering safe, compassionate care to increasingly diverse patient populations.

Student Journal Club to Improve Cultural Humility with LGBTQ Patients.

Health degree programs provide opportunities to reduce disparities in care for LGBTQ patients by exposing students to LGBTQ communities and current health issues. However, LGBTQ content is mostly absent from medical school curricula. This mixed method assessment study, conducted during the 2018 to 2019 academic year, examined the feasibility of implementing a medical student journal club focused specifically on LGBTQ health issues as a complementary training tool to support efforts to create an inclusive educational environment. Compared to the pre-test, mean response scores increased for most of the parameters including familiarity with LGBTQ healthcare issues, confidence in the ability to identify harmful medical provider practices, and reading and assessing scientific literature. Qualitative data showed increased confidence, comfort and knowledge about LGBTQ health barriers. This study offers a framework for using a journal club to provide an effective platform for enhancing students’ LGBTQ cultural humility and research literacy.

A Novel Curriculum for Medical Student Training in LGBTQ Healthcare: A Regional Pathway Experience.

Background:Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face considerable health disparities, often due to a lack of LGBTQ-competent care. Such disparities and lack of access to informed care are even more staggering in rural settings. As the state medical school for the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine (UWSOM) is in a unique position to train future physicians to provide healthcare that meets the needs of LGBTQ patients both regionally and nationally.Objective:To describe our methodology of developing a student-driven longitudinal, region-wide curriculum to train medical students to provide high-quality care to LGBTQ patients.Methods:A 4-year LGBTQ Health Pathway was developed and implemented as a student-led initiative at the UWSOM. First- and second-year medical students at sites across the WWAMI region are eligible to apply. Accepted Pathway students complete a diverse set of pre-clinical and clinical components: online modules, didactic courses, longitudinal community service/advocacy work, a scholarly project, and a novel clinical clerkship in LGBTQ health developed specifically for this Pathway experience. Students who complete all requirements receive a certification of Pathway completion. This is incorporated into the Medical Student Performance Evaluation as part of residency applications.Results:The LGBTQ Health Pathway is currently in its fourth year. A total of 43 total students have enrolled, of whom 37.3% are based in the WWAMI region outside of Seattle. Pathway students have completed a variety of scholarly projects on LGBTQ topics, and over 1000 hours of community service/advocacy. The first cohort of 8 students graduated with a certificate of Pathway completion in spring 2020.Conclusions:The LGBTQ Health Pathway at UWSOM is a novel education program for motivated medical students across the 5-state WWAMI region. The diverse milestones, longitudinal nature of the program, focus on rural communities, and opportunities for student leadership are all strengths and unique aspects of this program. The Pathway curriculum and methodology described here serve as a model for student involvement and leadership in medical education. This program enables medical students to enhance their training in the care of LGBTQ patients and provides a unique educational opportunity for future physicians who strive to better serve LGBTQ populations.

Improving Communication with LGBTQ Patients: A Pilot Curriculum During the Psychiatry Clerkship.

Improving Communication with LGBTQ Patients: A Pilot Curriculum During the Psychiatry Clerkship.

Courts Strike Down Trump’s ‘Refusal of Care’ Conscience Rule

Courts Strike Down Trump’s ‘Refusal of Care’ Conscience Rule

<p>Perioperative Provider and Staff Competency in Providing Culturally Competent LGBTQ Healthcare in Pediatric Setting</p>

IntroductionChildren and adolescents identifying as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) may feel reluctant to seek medical care due to stigma and the possibility of negative interactions with health care providers. Due to the short duration of the perioperative period, the interaction in this setting is limited and providers may not have the time to develop a rapport with the patient. It is imperative that staff are trained to address the patient and family in a culturally competent manner.MethodsWe undertook surveys before and after a 2 part educational series among the pediatric perioperative staff to understand the impact of providing education and cultural competency training regarding caring for patients who identify as LGBTQ. Providers self-reported their knowledge and comfort on a 1–5 point scale (5 being most knowledgeable or comfortable) in 6 domains of caring for LGBTQ patients. Objective knowledge of LGBTQ issues was assessed using 7 questions based on lecture material. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.ResultsThe analysis included 90 responses. Before training, median ratings of knowledge and comfort were 3 or 4 out of a maximum of 5 for each domain. The pre-training median score on the 7-item test of LGBTQ cultural competency was 5 (IQR: 4, 6). After training, knowledge and comfort self-ratings did not improve, but the score on the objective knowledge test increased to a median of 6 (IQR: 4, 7; p=0.011) of 7 possible points.DiscussionAnesthesia providers participating in LGBTQ cultural competency training self-reported high levels of knowledge and comfort with providing care to LGBTQ patients even before formal training was provided. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.

Improving lesbian, gay, bisexual, transgender, and queer/questioning health: Using a standardized patient experience to educate advanced practice nursing students.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons account for 3.5% of the population. Nursing programs in the United States provide a median of 2.13 hours of formal content regarding LGBTQ health, which contributes to iatrogenic barriers to care. Patient experiences related to inadequate provider preparation include misguided treatment strategies, impedance of communication, and abuse. A pilot educational project was developed to provide advanced practice nursing (APRN) students meaningful clinical interactions with LGBTQ-identifying standardized patients (SPs) to better prepare them to care for LGBTQ patients with cultural humility. This project was determined to be Exempt by the Institutional Review Board at the University of Michigan. Implemented in an advanced health assessment course with 99 APRN students, components of the project included course readings, lecture content, laboratory activities, an SP experience, and both large and small debriefing sessions. The SP experience itself was a 15-minute clinical encounter with a patient presenting with "abdominal pain," with an emphasis on history-taking, communication, and cultural humility. Qualitative data analysis was performed using the constant comparison method to interpret the results from student evaluations and other written feedback. This pilot project has promise to inform future educational offerings and set the standard for LGBTQ health content and application for APRN students. Further research is needed to evaluate the quality of LGBTQ content in APRN curricula to improve the ability of APRN students to provide care to LGBTQ patients.

Medical Student Perspectives on LGBTQ Health.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) community members experience adverse health outcomes at higher rates than non-LGBTQ individuals. We examined the impact of student demographics as well as gender and sexuality didactic instruction on the attitudes of first-year medical students toward LGBTQ patients. In January 2017, 255 first-year students at an urban allopathic medical school participated in a gender and sexuality health curriculum. We assessed student attitudes regarding LGBTQ patients using anonymous pre- and postintervention surveys. Each item was measured on a 5-point Likert scale. Of 255 possible respondents, we received 244 responses to the preintervention survey (95.7% response rate) and 253 to the postintervention survey (99.2% response rate). Participants were predominantly white (66.8%), heterosexual (94.7%), and cisgender (100%). Respondents who identified as LGBQ were significantly (P<.05) more likely than heterosexual students to agree with the following preintervention statements, among others: (1) Discordance between birth sex and gender is a natural human phenomenon, (2) When meeting a patient for the first time, I feel comfortable asking what pronoun they use, (3) I am able to empathize with the life experience of an LGB/T patient, (4) I am motivated to seek out opportunities to learn more about LGBTQ-specific health care issues. Statistically significant changes in attitudes between time points are seen in 4 out of 15 items. A focused gender and sexuality curriculum appears to impact medical student attitudes regarding LGBTQ patients. Furthermore, recruitment of LGBTQ-identifying medical students may translate into improved workforce motivation to provide health care for LGBTQ patients.

‘Conversion Therapy’ Misleads, Harms Patients

‘Conversion Therapy’ Misleads, Harms Patients

Using Simulation to Improve Students’ Proficiency in Taking the Sexual History of Patients Identifying as LGBTQ: A Pilot Study

BackgroundSelf-disclosure of sexual orientation is one of the most difficult things to share with health care providers. A fear of stigmatization or discrimination, coupled with health care providers' lack of knowledge about lesbian, gay, bisexual, transgender, and queer (LGBTQ)-specific health issues, creates an environment that makes it difficult to divulge one's sexual orientation. MethodsThe researchers sought to determine whether a low-fidelity simulation using role-playing and structured sexual history scenarios impacted students' self-confidence in taking sex histories and providing culturally competent care for LGBTQ patients. Using pretest–post-test survey methodology, researchers used the gay affirmative practice scale that measures the beliefs of health care providers regarding LGBTQ clients. ResultsA paired samples t-test revealed a statistically significant difference in pretest (M = 64.2, SD = 7.4) versus post-test (M = 70.0, SD = 6.7) mean scores, t(75) = -13.4, p < .000. ConclusionThe findings from this study suggest that the simulation is effective in improving students' gay affirmative practice beliefs.

Author of Boy Erased to Speak at IPS

Back to table of contents Previous article Next article Institute on Psychiatric ServicesFull AccessAuthor of Boy Erased to Speak at IPSAmir K. Ahuja, M.D.Amir K. AhujaSearch for more papers by this author, M.D.Published Online:30 Aug 2019https://doi.org/10.1176/appi.pn.2019.9a16AbstractAt this year’s IPS Conference, AGLP: The Association of LGBTQ Psychiatrists is very excited to present several symposia. In case anyone is unaware, this organization is an allied organization of APA and works diligently to ensure that LGBTQ psychiatrists and LGBTQ patients do not encounter discrimination. In particular, we are committed to ensuring that legislation and the practice of mental health care are designed to improve health outcomes for LGBTQ patients and eliminate current health disparities.One of the sessions we are presenting is the symposium “Conversion Therapy: Boy Erased, Can It Alter Sexual Orientation Without Causing Harm?” Conversion therapy is the practice of trying to change a person’s sexual orientation or gender identity through psychotherapy as well as with other behavioral modification techniques. Such practices are not supported by science and are dangerous, and laws are being enacted around the country to protect individuals, particularly minors, from being subjected to this therapy.In this symposium, we will be showing the 2018 film “Boy Erased,” which stars Lucas Hedges as real-life teen Garrard Conley as he was subjected to conversion therapy by his fundamentalist Arkansas family. The movie highlights the tragic outcomes that are all too common when patients undergo conversion therapy, including depression and suicide. Ultimately, it shows how Garrard and his family come to accept his homosexuality and begin to heal. After the movie, the session panelists, including me, will lead a discussion on the statistics and legal status of conversion therapy and the data showing the harm it can do.Finally, the author of the book on which the film is based and the person whose story is represented in the film, Garrard Conley, is going to speak about his experience. This will be followed by a discussion with him about what can be done to end this harmful practice. ■“Conversion Therapy: Boy Erased, Can It Alter Sexual Orientation Without Causing Harm?” will be held Friday, October 4, at 1 p.m. See box below for additional information about IPS, including registration.Amir K. Ahuja, M.D., is director of psychiatry at the Los Angeles LGBT Center, president-elect of the Association of LGBTQ Psychiatrists, and secretary of GLMA: Health Professionals Advancing LGBTQ Equality. ISSUES NewArchived

Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review

BackgroundLesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients.MethodsThe authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale.ResultsThe search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers.ConclusionsStrategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

Navigating medical culture and LGBTQ identity.

Contextualised within minority stress theory, this study explores the experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) medical students and how they navigate medical school as sexual minorities. Past research indicates many LGBTQ medical students have witnessed medical school staff make prejudice comments about LGBTQ patients, leading sexual minority students to suppress LGBTQ identities and experience adverse mental health outcomes. Focus groups were conducted with 12 LGBTQ medical students from four different Michigan-based medical schools. Findings show that LGBTQ medical students have a difficult time managing their sexual minority status, but non-white LGBTQ medical students experience medical school at an intersection of sexual-identity oppression and racial discrimination. LGBTQ medical students abandon hopes of creating close relationships with faculty members and educators because they have witnessed them make derogatory comments towards LGBTQ patients. The burden of performing well academically and suppressing important aspects of the students' identities creates a stressful work environment that contributes to poor mental health. 'Don't let the doctors know about your sexuality because they might know someone whoknows someone. …' DISCUSSION: Based on this study's findings, there are two recommendations. First, medical school staff should foster a more inclusive environment for students that disrupts the dominance of heteronormative standards, which ultimately underpins LGBTQ health disparities, more generally. Second, medical school faculty members should show their support to LGBTQ students so they can recognise allies and create supportive networks through these individuals. These relationships could encourage students to become successful professionally, but also promote confident and positive feelings about their identities.

Assessing Provider Needs on LGBTQ Health To Develop and Effectively Deliver LGBTQ Health Curriculum for Providers

Purpose of Study: LGBTQ youth continue to be a population who face significant health disparities, often due to the fact that many medical providers do not feel prepared to address LGBTQ-specific concerns. Our study aimed to assess providers’ comfort and familiarity with these issues. Once knowledge gaps were identified, we educated our providers in an attempt to provide better care for a more at risk patient population. Methods Used: We assessed pediatric residents’ and attendings’ knowledge and comfort in providing care for LGBTQ patients using a …

“I’ll take Gender Identity for 500”- Changing knowledge and comfort in the care of LGBTQ patients with a novel training approach.

“I’ll take Gender Identity for 500”- Changing knowledge and comfort in the care of LGBTQ patients with a novel training approach.

A Curriculum Development and Education Activity: Improving Pediatric Provider Comfort in Caring for LGBTQ Patients

A Curriculum Development and Education Activity: Improving Pediatric Provider Comfort in Caring for LGBTQ Patients

Improving the Knowledge, Attitudes, and Behavioral Intentions of Perinatal Care Providers Toward Childbearing Individuals Identifying as LGBTQ: A Quasi-Experimental Study.

This study explores the impact of gender and sexuality awareness training on perinatal health care providers' (HCPs') knowledge, attitudes, and intended behavior toward childbearing individuals identifying as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). A nonrandom convenience sample of HCPs (n = 187) comprised an experimental group (n = 99) who attended grand rounds trainings covering gender and sexuality topics and a control group (n = 88) who attended sessions on other unrelated topics. All participants completed a pre-posttraining questionnaire to assess changes in knowledge, attitudes, and intended behavior toward LGBTQ patients. Participants in the experimental group demonstrated significant improvement in knowledge, misconception, prejudice, sensitive language, and normativity regarding LGBTQ pregnant patients from pretest to posttest. These findings suggest that a 40-minute gender and sexuality training can immediately improve HCPs' knowledge, attitudes, and intended behavior toward LGBTQ childbearing patients. [J Contin Educ Nurs. 2019;50(7):303-312.].

Increasing cultural competence with LGBTQ patients

Increasing cultural competence with LGBTQ patients